Different Modalities of Management of Liver Abscess and its Surgical Outcome - An Observational Study

BACKGROUND: Liver abscess is a common condition in India. India has 2nd highest incidence of liver abscess in the world. Pyogenic abscess accounts for three quarters of hepatic abscess in developed countries. While amoebic liver abscess cause two third liver abscess in developing countries. Amoebiasis is presently the third most common cause of death from parasitic disease. The world health organisation reported that Entamoeba Histolytica causes approximately 50 million cases and 100000 deaths annually liver abscess continues to be disease with considerable mortality in India. Liver abscess has an increasing incidence rate in United States and Europe Modern treatment has shifted towards IV broad spectrum antibiotics and image guided percutaneous needle aspiration or percutaneous catheter drainage and surgical drainage. Treatment of liver abscess were improved significantly with the introduction of ultrasound and computed tomography METHODOLOGY: This was A prospective observational Study was conducted in department of surgery GMC Bhopal, from March 2017 to august 2018 entitled �Study of Different Modalities of Management of Liver Abscess and Its Outcome. Total number of 250 patients was included in this study with the diagnosis of liver abscess. RESULTS: Out of 250 patients, 54 (84.6 %) patients responded to drug therapy alone.55 (86 %) required ultrasound guided needle aspiration, 105 (91.4 %) patient responded to ultrasound guided pigtail placement and 6 (85.2) patient with ruptured liver abscess treated successfully with surgical drainage. Most common signs and symptoms, pain in abdomen (n=216), fever (n= 214), nausea and vomiting (n = 175) and weight loss (n= 175). Among the successfully treated patient the average time of mean hospital stay and average time for clinical improvement were slightly different among groups. Early alleviation of symptoms and resolution of abscess cavity present in surgical drainage and pigtail catheter drainage. CONCLUSION: Majority of patients with unruptured liver abscess can be managed without conventional surgical drainage with image guided percutaneous catheter drainage as modality of choice.