Liver Abscess in Pediatric Patients - Our Institutional Experience

Background: A liver abscess most often occurs because of infection from germs such as bacteria or parasites (Amoebic). The classic signs and symptoms of fever, abdominal pain, jaundice, and liver enlargement occur infrequently, which is why the diagnosis is often missed. The incidence of amoebic liver abscess varies all over the world and large numbers of cases found in developing countries remain unreported. In pyogenic liver abscess, infection may spread to liver from other structures in abdomen, such as the gallbladder, bile ducts, bowels or appendix. Infection may travel from bloodstream to liver from more distant areas of the body. Material and Methods: This was a prospective study, carried out at our tertiary care center, from September 2018 to April 2020. Ninety patients (male: 50, female: 40) were enrolled in this study. Results and Discussion: We found male preponderance (55.56%) in this study. The most common presenting symptom was Anorexia (97.78%), followed by abdominal pain (93.33%) and fever (92.22%). Single cavity abscesses (85.55%) were more common than multiple cavity abscesses. Right lobe abscesses were more than left lobe abscesses. Amoebic liver abscesses were more common than pyogenic liver abscesses. Multiple cavity abscesses were more common in pyogenic abscesses than amoebic abscesses. The most common organism found on culture was Staphylococcus (42.80%) followed by E. coli (28.57%), Klebsiella (19%) and Enterococcus (9.5%). Conclusion: USG is the standard modality for diagnostic and therapeutic management as well as for drainage and follow up. According to our study USG guided pigtail catheter drainage is a superior therapeutic approach than needle aspiration for large liver abscess, because abscess cavity resolves better in case of pigtail catheter drainage.