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Category: Volume 06 Issue 08 August 2018
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Title: A prospective study of ultra-sonographic and radiological profile of patients with liver abscess

Authors: Dr Maneesh Jain, Dr Abhay S. Tirkey

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i8.05

Abstract

Background: Liver abscess is fairly common in developing countries like India due to inadequate sanitation, overcrowding and poor nutrition. Yet, there is limited data on ultra-sonographic and radiological profile at the medical wards.

Aims and Objective: To evaluate patient with liver abscess for radiological abnormality, its treatment and outcome.

Materials and Methods: Hundred and four liver abscess patients diagnosed on the basis of ultrasonography were studied in the Department of Medicine, GR Medical College and J A Group of Hospital, Gwalior from November 2009 to October 2011. All patients were examined clinically along with radiological assessment and assessed for optimal management and outcome. Ultrasonography was done for site, size, number, echogenicity and any other abnormality. On the basis of microbiological study, three groups were formed; Amoebic Liver Abscess (ALA) group (n=39), Pyogenic Liver Abscess (PLA) (n=28) group and Not Aspirated (NA) Group (n=37).

Results: ALA was more prevalent (58.2%) with male preponderance (90.1% in ALA and 60.7% in PLA group) (p= 0.0038). Most of the patients had age <40 years (92.3% in ALA group vs. 17.8%in PLA group; p= 0.003). Single abscess was seen in majority of ALA group (84.6%) whereas multiple abscesses were seen in PLA group (75%). Right lobe of liver (76.7%) was mostly involved in ALA, whereas in PLA left or both lobes were involved. ALA was mostly >10cm (56.1%) in size while PLA were between 5-10cm (71.4%) in size. Chest X-ray abnormality was more in PLA (50%) compared to ALA group (35.8%). Most common micro organism found in PLA was E coli (39%) whereas, PLA patient showed a mixed bacterial growth (32.1%). In ALA group 35.9% patient required percutaneous aspiration whereas, in PLA 46.4% patient required percutaneous aspiration.  Two patients died in PLA group.

Conclusion: In patients with PLA multiple abscess, left lobe involvement and with pulmonary finding were mostly common whereas ALA occurs with solitary and right lobe abscess. ALA can be managed without aspiration compared to PLA.

Keywords: Mixed infection, liver abscess, aspiration, ultrasound-guided percutaneous needle aspiration.

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Corresponding Author

Dr Abhay S. Tirkey

GRMC & JAH, Gwalior, MP, India

Email: This email address is being protected from spambots. You need JavaScript enabled to view it., Mobile: 9981351280