Pyogenic liver abscesses: 13 years of experience in percutaneous needle aspiration with US guidance.
OBJECTIVE
To determine the efficacy of percutaneous needle aspiration (PNA) with antibiotic therapy in treatment for pyogenic liver abscess (PLA).


METHODS
One hundred fifteen patients (59 male; 56 female; age range, 16-86 years; mean age, 45.3 years) with 147 PLAs (mean diameter, 6.8 cm; range, 3-16 cm) underwent PNA with ultrasound (US) guidance and antibiotic therapy. Needle caliber (22-16 gauge) was tailored to PLA volume. If necessary, PNA was repeated every 3-7 days.


RESULTS
Three hundred one PNAs were performed (range, 1-4 per patient; mean, 2.2 per patient). A single puncture was sufficient in 57 patients. Cure (normalization of clinical and laboratory parameters and resolution of hepatic lesions) was achieved in 113 patients (98.3%). Two patients with large PLAs required surgery. Patients were hospitalized 7-24 days (mean, 9 days). In the last eight patients, all abscesses were evacuated in one session. Neither complications nor deaths ensued. Recurrence of PLA was not observed in any patient during follow-up (6-36 months).


CONCLUSIONS
US-guided PNA with antibiotic therapy in treatment for PLA is a valid alternative to prolonged catheter drainage.
Giorgio
A
A
Department of Interventional Ultrasound, Cotugno Hospital for Infectious Disease, Naples, Italy.
Tarantino
L
L
Mariniello
N
N
Francica
G
G
Scala
E
E
Amoroso
P
P
Nuzzo
A
A
Rizzatto
G
G
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001420:Bacteria, Aerobic; D001421:Bacteria, Anaerobic; D001424:Bacterial Infections / Q000000981:diagnostic imaging / Q000382:microbiology / Q000628:therapy*; D003131:Combined Modality Therapy; D004322:Drainage / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008100:Liver Abscess / Q000000981:diagnostic imaging / Q000382:microbiology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009339:Needles; D012189:Retrospective Studies; D013396:Suction / Q000379:methods; D013997:Time Factors; D018084:Ultrasonography, Interventional
D000900:Anti-Bacterial Agents