title: Liver abscess. The need for complete gastrointestinal evaluation.
abstract: The cause of liver abscess is frequently obscure at initial presentation. We reviewed the medical records of 20 patients with pyogenic liver abscess over a 6-year period from 1981 to 1987. Liver abscess was suspected in only 3 patients on admission; the most common initial diagnosis was fever of unknown origin. Subsequently, the origin of the abscess was found to be intestinal in 7 patients, pancreatobiliary in 11 patients, and cryptogenic in 2 patients. Eleven patients underwent percutaneous transhepatic drainage of the abscess as the initial treatment, while open operation was the initial treatment in 9 patients. Percutaneous transhepatic drainage was ultimately successful in only 4 patients (36%). In the absence of an obvious pathologic condition of the biliary tract, all patients should undergo full gastrointestinal evaluation.
authors.affiliation: Department of General Surgery, Lahey Clinic Medical Center, Burlington, Mass. 01805.
authors.forename: J L
authors.initials: JL
authors.lastname: Cohen
authors.forename: F M
authors.initials: FM
authors.lastname: Martin
authors.forename: R L
authors.initials: RL
authors.lastname: Rossi
authors.forename: D J
authors.initials: DJ
authors.lastname: Schoetz
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001419:Bacteria / Q000302:isolation & purification; D004066:Digestive System Diseases / Q000150:complications / Q000175:diagnosis*; D004322:Drainage / Q000009:adverse effects / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008100:Liver Abscess / Q000209:etiology* / Q000401:mortality / Q000628:therapy; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D012189:Retrospective Studies