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[Pyogenic liver abscess. A descriptive study of 35 cases]
A Ramos1, T Gazapo, J Murillas
1Servicios de Medicina Interna III, Clinica Puerta de Hierro. Madrid.
Gastroenterologia Y Hepatologia
|June 1, 1996
Summary
Pyogenic hepatic abscess (PHA) diagnosis is best achieved with abdominal echography. Antibiotic treatment alone leads to a worse prognosis for PHA patients compared to those receiving antibiotics and drainage.
Area of Science:
- Hepatology
- Infectious Diseases
- Radiology
Background:
- Pyogenic hepatic abscess (PHA) is a serious infection requiring effective diagnostic and treatment strategies.
- Clinical manifestations often include fever and leukocytosis, with less frequent findings like abdominal pain and elevated liver enzymes.
Purpose of the Study:
- To evaluate the utility of opaque enemas in diagnosing cryptogenic PHA.
- To assess the prognosis of patients with PHA treated solely with antibiotics versus those receiving antibiotics and drainage.
Main Methods:
- Retrospective study of 35 patients with PHA over 13 years.
- Analysis of clinical, analytical, and radiological findings.
- Evaluation of diagnostic yield of colon studies and abdominal echography.
- Comparison of treatment outcomes based on antibiotic therapy alone versus combined antibiotic and drainage therapy.
Main Results:
- Colon studies for cryptogenic PHA showed low diagnostic profitability.
- Abdominal echography demonstrated high sensitivity (0.85) for PHA diagnosis and facilitated percutaneous drainage.
- Patients treated with antibiotics and drainage had a significantly better prognosis (p = 0.03) and shorter fever duration than those treated with antibiotics alone.
Conclusions:
- Abdominal echography is a sensitive and effective tool for diagnosing PHA and guiding percutaneous drainage.
- Percutaneous drainage in conjunction with antibiotics significantly improves patient prognosis and reduces fever duration in PHA cases.