[Pyogenic hepatic abscesses: 16 years experience in its diagnosis and treatment]

The aim of the present was to know the epidemiologic characteristics and clinico-biological variables presented by pyogenic hepatic abscesses and to evaluate the different therapeutic alternatives with special emphasis on percutaneous drainage.

A historical retrospective review of the hepatic abscesses diagnosed and treated in the authors' hospital over a 16.5 year period was carried out.

A total of 44 cases of pyogenic hepatic abscesses were collected representing a rate of 0.088% of the hospital admissions. The mean age of the patients was 61.8 years. Thirty-four percent were cryptogenetic, being followed in frequency by those of biliary, post abdominal surgery and venoportal origin. Fever and right hypochondrial pain were the most frequent clinical manifestations, accompanied by an elevation in VSG and leucocytosis being the most common analytical alterations. Ultrasonography and CAT were found to be valuable in the diagnosis and treatment. The microorganism responsible was identified in 48% of the cases, with enterobacteria being the greatest number isolated. Fifty-two percent of the abscesses were treated with percutaneous drainage (73% if only patients post 1984 are considered), with minimum complications and a reduction in the number of days of hospitalization in comparison with surgical treatment.

The presentation of a pyogenic hepatic abscess may be unspecific. Imaging techniques (echography and CAT) provide the main support in both the diagnosis and treatment. Percutaneous drainage plus early empiric antibiotherapy are the treatment of choice in pyogenic hepatic abscesses.