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Published on: August 14, 2017
[Liver abscess: diagnosis and treatment. Study of a series of 22 cases]
M Benazzouz1, R Afifi, A Ibrahimi
1Clinique Médicale C, Hôpital Avicenne, RABAT, Maroc.
Abstract:
Twenty-two cases of abscess of the liver are reported. Eighteen were due to pyogenic organisms and four to amebas. The diagnosis was established based on clinical and laboratory evaluations and, above all, on ultrasonography with aspiration of the lesion. The causative organism was recovered from the aspirate in 33.3% of cases. Seventeen patients were treated by percutaneous aspiration. Two patients required insertion of a drain because of a biliary fistula. The success rate of percutaneous aspiration with or without drainage was 88.2% in our series. The two patients who had surgery had loculated abscesses with thick pus. In conclusion, the diagnosis and treatment of hepatic abscesses have benefited from advances in imaging techniques; in particular, aspiration or drainage can be performed simply under ultrasonographic guidance.
Insights
Diagnosing and treating liver abscesses, whether pyogenic or amebic, is now simpler with advanced imaging. Ultrasonography-guided aspiration or drainage offers a high success rate for hepatic abscess management.
Area of Science:
- Hepatology
- Infectious Diseases
- Radiology
Background:
- Liver abscesses are serious infections requiring timely diagnosis and effective treatment.
- Both pyogenic bacteria and amebas can cause liver abscesses, necessitating accurate etiological identification.
- Traditional diagnostic methods can be supplemented by advanced imaging for improved accuracy.
Purpose of the Study:
- To report on the diagnosis and management of liver abscess cases.
- To evaluate the efficacy of ultrasonography-guided percutaneous aspiration and drainage.
- To assess the outcomes of different treatment modalities for hepatic abscesses.
Main Methods:
- Retrospective review of twenty-two liver abscess cases.
- Diagnosis based on clinical, laboratory, and ultrasonography findings.
- Treatment involved percutaneous aspiration, drainage, or surgery.
Main Results:
- Eighteen abscesses were pyogenic, and four were amebic.
- Ultrasonography with aspiration was key to diagnosis.
- Percutaneous aspiration/drainage achieved an 88.2% success rate.
- Surgery was reserved for complex, loculated abscesses.
Conclusions:
- Advances in imaging, particularly ultrasonography, have significantly improved liver abscess diagnosis.
- Ultrasonography-guided percutaneous aspiration and drainage are effective and minimally invasive treatment options.
- Effective management of hepatic abscesses relies on accurate diagnosis and appropriate intervention guided by imaging.
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