[Clinical aspects, etiology, diagnosis and therapy of liver abscess. A retrospective study 1984-1991].
In a retrospective study (1984-1991) we evaluated 56 patients with pyogenic (44 patients) and with amebic (12 patients) liver abscesses. Patients with pyogenic liver abscesses usually belong to the older generation (70-80 years). Pyogenic abscesses are mainly due to a severe underlying disease and patients are in poor general condition. Therapy includes antibiotics and in most cases drainage (nowadays mainly percutaneous; surgical drainage should only be used with a simultaneous intraabdominal procedure for treatment of the underlying disease). The mean hospitalization time is 33 days. Prognosis is good, the mortality of 14% being mainly due to severe underlying disease. This latter can be found in 75% of the patients and should be treated electively. In amebic liver abscesses the patients are much younger (around 30 years). Patients are in good general condition and antibiotics alone are sufficient for radical treatment. The mean hospitalization time is 16.5 days and mortality is zero. Symptoms and clinical signs are the same in both groups: fever, right upper quadrant tenderness, jaundice and hepatomegaly. Diagnosis by ultrasonography and/or computed tomography is very reliable. History and serology are reliable for differentiation of the two types. With a correct diagnostic approach and treatment, liver abscesses are today benign conditions with a low mortality.
Schweizer
W
W
Universitätsklinik für Viszerale und Transplantationschirurgie, Inselspital Bern.
Berthold
M
M
Naef
M
M
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D004322:Drainage; D005260:Female; D006801:Humans; D007902:Length of Stay; D008100:Liver Abscess / Q000401:mortality / Q000628:therapy*; D008101:Liver Abscess, Amebic / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies
D000900:Anti-Bacterial Agents
Klinik, Atiologie, Diagnostik und Therapie von Leberabszessen. Eine retrospektive Ubersichtsarbeit 1984-1991.