A clinical study of liver abscess in patients attending the surgical department; A single center experience
Cerrahi kliniğine gelen hastalarda karaciğer apsesinin klinik analizi. Tek merkez deneyimi.
Keywords:
Amoebic liver abscess, pyogenic liver abscess, metronidazole, needle aspiration.Abstract
Liver abscess is a condition that is seen by surgeons all over the world. The patients present to the surgical department with features of right hypocondrial pain, fever and jaundice. Investigations such as ultrasound of the abdomen and CT scan of the abdomen are extremely useful in diagnosing a case of liver abscess. The two main causes of liver abscess are amoebic and pyogenic liver abscess. Occasionally a liver abscess may also occur due to fungal infection. Treatment modalities include the use of drugs such as metronidazole for amoebic liver abscess, as well as needle aspiration and pigtail catheter drainage when required. This was a prospective study was carried out from August 2015 to July 2018, for a period of three years. The study was conducted at SRM Medical College Hospital and Research Center, Kattankulathur, Tamil Nadu, India. Investigations such as complete blood count (CBC), chest x-ray, x-ray abdomen, ultrasound of the abdomen and CECT of the abdomen were done. A total of 57 patients were studied and the results obtained were analysed.
ÖZET
Karaciğer apsesi, tüm dünyadaki cerrahlar tarafından karşılaşılan bir durumdur. Hastalar sağ hipokondriyal ağrı, ateş ve sarılık özellikleri ile cerrahi bölümüne başvururlar. Karın ultrasonu ve karın BT taraması gibi araştırmalar karaciğer apsesi teşhisinde son derece yararlıdır. Karaciğer apsesinin iki ana nedeni amipli ve piyojenik karaciğer apsesidir. Bazen mantar enfeksiyonu nedeniyle de karaciğer apsesi oluşabilir. Tedavi yöntemleri arasında amipli karaciğer apsesi için metronidazol gibi ilaçların yanı sıra iğne aspirasyonu ve gerektiğinde pigtail kateter drenajı yer alır. Prospektif çalışmamızda Ağustos 2015'ten Temmuz 2018'e kadar üç yıllık bir süre boyunca kliniğimize gelen hastalar değerlendirmeye alındı. Çalışma SRM Medical College Hastanesi ve Araştırma Merkezi, Kattankulathur, Tamil Nadu, Hindistan'da gerçekleştirildi. Tam kan sayımı (CBC), göğüs röntgeni, karın röntgeni, karın ultrasonu ve karın CECT gibi incelemeler yapıldı. Toplam 57 hasta incelendi ve elde edilen sonuçları analiz edildi.
References
Mohsen AH, Green ST, Read RC, McKendrick MW. Liver abscess in adults: ten years experience in a UK centre. QJM 2002;95(12):797-802.
Tiwari D, Jatav OP, Jain M, Kumar S. Study of clinical and etiopathological profile of liver abscess. J of Evidence Based Med and Healthcare 2015;2(40):6705-12.
Rajak CL, Gupta S, Jain S, Chawla Y, Gulati M, Suri S. Percutaneous treatment of liver abscesses: needle aspiration versus catheter drainage. Am J Roentgenol 1998;170(4):1035-9.
Abdullah AA. Clinical analysis of Amoebic liver abscess. IJGE 2005;5(1):35-8.
Ahsan T, Jehangir MU, Mahmood T, Ahmed N, Saleem M, Shahid M, et al. Amoebic versus pyogenic liver abscess. J Pak Med Assoc 2002;52(11): 497-501.
Goh KL, Wong NW, Paramsothy M, Nojeg M, Somasundaram K. Liver abscess in the tropics: experience in the University Hospital, Kuala Lumpur. Postgrade Med J 1987;63(741):551-4.
Bukhari AG, Abid KG. Amebic liver abscess: clinical presentation and diagnostic difficulties. KMJ 2003:183-6.6.
Chou FF, Sheen?chen SM, Chen YS, Chen MC. Single and multiple pyogenic liver abscesses: clinical course, etiology and results of treatment, World J Surg 1997;21(4)384-8.
Makkar RP, Sachdev GK, Malhotra V. Alcohol consumption, hepatic iron load and the risk of amoebic liver abscess: a case-control study. Internal Medicine 2003;42(8):644-9.
Khan RA, Hameed F, Bashir MB, Rana MM, Mazhar HR. Amebic liver abscess; incedence and outcome. Professional Med J 2010;17(4).
Qazi AR, Naqvi SQ, Solangi RA, Memon JM, Lashari A. Liver Abscess: Diagnosis and Treatment. Pakistan J Surg 2008;24:203-7.
Powell SJ, Macleod I, Wilmot AL, Elsdon-Dew E. Metronidazole in amoebic dysentery and amoebic liver abscess. Lancet 1966;2(7477):1329-31.
Pang TC, Fung T, Samra J, Hugh TJ, Smith RC. Pyogenic liver abscess: An audit of 10 years? experience. World J Gastroenterol 2011;17(12): 1622-130.
Wang JH, Liu YC, Lee SS, Yen MY, Chen YS, Wang JH, et al. Primary Liver Abscess due to Klebsiella pneumonia in Taiwan. Clin Inf Dis 1998;26(6):1434-8.
Ramani A, Ramani R, Kumar MS, Lakhkar B, Kundaje GN. Ultrasound guided needle aspiration of amoebic liver abscess. Postgrad Med J 1993; 69(811):381-3.
Giorgio A, Amoroso P, Francica G, de Stefano G, Fico P, Lettieri G, et al. Echo guided percutaneous puncture: a safe and valuable therapeutic tool for amoebic liver abscess. Gastrointest Radiol 1988; 13(4):336-40.
Zerem E, Hadzic A. Sonographically guided Percutaneous catheter drainage versus Needle aspiration in the management of Pyogenic liver abscess. Am J Radiol 2007;189(3):W138-42.
McGarr PL, Madiba TE, Thomson SR, Corr P. Amoebic liver abscess-Results of a conservative management policy. SAMJ 2003;93(2):132-6.
Perez CI. Thoracic complications of Amoebic abscess of Liver. Chest 1981;79(6):672-7.
