Liver abscess of hydatid origin: clinical features and results of aggressive treatment.
BACKGROUND
Cyst infection and subsequent liver abscess formation are complications of liver echinococcosis. Traditionally, this condition has been treated by simple drainage, a procedure associated with unsatisfactory postoperative evolution.


METHODS
The present paper examines a series of cases involving infected liver echinococcal cysts. Surgery was performed at the Temuco Regional Hospital after assessment was made of general and liver laboratory parameters, chest X-ray and abdominal ultrasound were performed and antibiotic treatment was administered. The procedure consisted of surgical drainage, parasite material extirpation and pericystic membrane resection with surrounding healthy liver parenchyma. The morbidity and mortality rate, hospital stay and evidence of recurrent hydatid disease were evaluated.


RESULTS
Forty-nine patients (21 male and 28 female), with a median age of 45 years (range 16-84 years), with infected cysts measuring 14 cm in ultrasonographical diameter (range 5-30 cm) were operated on. In the majority of cases, liver abscesses were located in the right lobe (37 patients, 75.4%) and the most frequent computed tomography scan pattern was heterogeneous (40 patients, 81.6%). The median hospital stay was 5 days, the median follow-up period was 32 months (range 2-91 months) and perioperative morbidity was 24.4%. Surgical complications were verified in five patients (10.2%) and medical complications occurred in seven cases (14.3%). No recurrence of hydatid disease was observed. Mortality was 2% (one patient).


CONCLUSIONS
Good results were obtained when hydatid liver abscesses were treated aggressively.
Manterola
Carlos
C
Department of Surgery and Evidence-Based Health Center (CIGES), Hospital Regional de Temuco and Universidad de La Frontera, Temuco, Chile. cmantero@ufro.cl
Barroso
Manuel
M
Vial
Manuel
M
Bustos
Luis
L
Muñoz
Sergio
S
Losada
Héctor
H
Bello
Nelson
N
Hernández
Francisco
F
Carrasco
Roberto
R
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004444:Echinococcosis, Hepatic / Q000150:complications* / Q000175:diagnosis* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008100:Liver Abscess / Q000175:diagnosis* / Q000209:etiology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed