Treatment of patients with pyogenic liver abscess.
BACKGROUND
Pyogenic liver abscess (PLA) remains a serious disease with a mortality of 6-14%.


METHODS
Clinical data of 76 patients with PLA were analyzed. Treatment options comprised antibiotics, percutaneous puncture/drainage, endoscopic papillotomy/stenting and/or surgery as indicated.


RESULTS
Fifty-eight patients (76%) had single and 18 patients multiple PLA (right lobe: 65%; both lobes: 22%). The most frequent etiologies were: biliary (38%), hematogenous and posttraumatic (11%). Factors associated with the need for surgery included gallbladder empyema, biliary fistulas, malignancy, perforation, multicentricity, vascular complications and foreign bodies (e.g. infected ventriculo-peritoneal shunt, toothpick).


CONCLUSIONS
Microbiological testing provides important information for treatment monitoring and modification. Complementary assessment of risk factors for a complicated course is crucial for timely identification of patients requiring additional treatment.
Cerwenka
H
H
Department of Visceral Surgery, Medical University of Graz, Austria. herwig.cerwenka@meduni-graz.at
Bacher
H
H
Werkgartner
G
G
El-Shabrawi
A
A
Kornprat
P
P
Bernhardt
G A
GA
Mischinger
H J
HJ
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001658:Biliary Fistula / Q000150:complications / Q000473:pathology; D018929:Cell Culture Techniques; D004322:Drainage; D005260:Female; D006801:Humans; D046290:Liver Abscess, Pyogenic / Q000175:diagnosis / Q000209:etiology / Q000601:surgery / Q000628:therapy*; D008297:Male; D008826:Microbial Sensitivity Tests; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
D000900:Anti-Bacterial Agents