title: Liver abscess of hydatid origin: clinical features and results of aggressive treatment.
abstract: 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.
authors.affiliation: Department of Surgery and Evidence-Based Health Center (CIGES), Hospital Regional de Temuco and Universidad de La Frontera, Temuco, Chile. cmantero@ufro.cl
authors.forename: Carlos
authors.initials: C
authors.lastname: Manterola
authors.forename: Manuel
authors.initials: M
authors.lastname: Barroso
authors.forename: Manuel
authors.initials: M
authors.lastname: Vial
authors.forename: Luis
authors.initials: L
authors.lastname: Bustos
authors.forename: Sergio
authors.initials: S
authors.lastname: Muñoz
authors.forename: Héctor
authors.initials: H
authors.lastname: Losada
authors.forename: Nelson
authors.initials: N
authors.lastname: Bello
authors.forename: Francisco
authors.initials: F
authors.lastname: Hernández
authors.forename: Roberto
authors.initials: R
authors.lastname: Carrasco
mesh_terms: 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