Pyogenic liver abscess: a 7-year experience in a large community hospital.
This is a retrospective study of 27 consecutive patients with a diagnosis of pyogenic liver abscess (PLA) seen over a period of 7 years. There were 10 males and 17 females whose ages ranged from 5 to 86 years (mean 56). Fever, abdominal pain and vomiting were the commonest symptoms, and abdominal tenderness was the commonest physical finding. An elevated alkaline phosphatase was seen in 78% of all patients and was the commonest biochemical abnormality. Biliary disease accounted for a third of all cases, and in 22% of the patients the abscesses were considered to be idiopathic. Ultrasonography and/or CT scanning was employed in the diagnosis and follow-up of all patients. Percutaneous needle aspiration (PNA) and percutaneous drainage (PCD) under ultrasound or CT guidance was employed as the primary therapy in 24 patients. The procedure failed in 5 patients (18.5%), there was 1 complication (3.7%) and no deaths were seen as a result of these procedures. Three patients (11%) ultimately died of their abscesses. This study emphasizes the important role of percutaneous drainage as a complementary form of therapy to surgical drainage in the management of pyogenic liver abscesses.
Department of Internal Medicine, William Beaumont Hospital, Royal Oak, MI.
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Bissada
J
J
Bateman
D004322:Drainage / Q000379:methods; D005260:Female; D006764:Hospitals, Community; D006801:Humans; D008100:Liver Abscess / Q000453:epidemiology* / Q000209:etiology / Q000601:surgery; D008297:Male; D008824:Michigan / Q000453:epidemiology; D008875:Middle Aged; D012189:Retrospective Studies