Percutaneous needle aspiration in the treatment of hepatic abscess: factors influencing patients' outcome.
Sixty-four consecutive cases of hepatic abscess diagnosed over a 6-year period and all treated by ultrasound-guided percutaneous needle aspiration and systemic antibiotics were retrospectively reviewed to ascertain factors influencing the outcome in these patients. The 64 patients had in total 101 liver abscesses which averaged 4.7 cm in diameter. Two patients (3.1%) required surgery for associated biliary tract disease. Five patients (7.8%) died from septicaemia and/or serious condition or malignancy. The remaining 57 patients (89.1%) were successfully treated--45 cases (70.3%) showed fully-resolved abscess/es after a mean period of 69.9 days after initial aspiration; 12 patients (18.8%) showed markedly-shrunken abscess cavity size over an average of 30.7 days and all were asymptomatic on discharge from hospital. No correlation was demonstrated between number of abscesses and successful patient recovery--42 of 46 patients (91.3%) with solitary hepatic abscess recovered, 6 of 8 patients (75.0%) with 2 abscesses and 9 of 10 patients (90.0%) with more than 2 abscesses were successfully treated. No correlation was detected between abscess size and number of aspirations required, majority of abscesses (73.3%) requiring no more than two aspirations irrespective of their sizes. Of the 57 patients cured, no significant correlation between abscess size and degree of abscess healing was evident. Our results demonstrate the effectiveness of percutaneous needle aspiration and it should be considered a first-line treatment in the management of liver abscess, irrespective of their number and sizes.
Lo
R H
RH
Department of Diagnostic Radiology, Singapore General Hospital, Singapore.
Yu
S C
SC
Kan
P S
PS
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001649:Bile Duct Diseases / Q000150:complications / Q000601:surgery; D001653:Bile Ducts, Intrahepatic / Q000473:pathology; D002423:Cause of Death; D002761:Cholangitis / Q000150:complications / Q000601:surgery; D002769:Cholelithiasis / Q000150:complications / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008100:Liver Abscess / Q000209:etiology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009339:Needles; D009369:Neoplasms / Q000150:complications; D019152:Paracentesis / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D012189:Retrospective Studies; D018805:Sepsis / Q000150:complications; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional; D014945:Wound Healing
D000900:Anti-Bacterial Agents