A Clinical Study of Hepatic Abscess with Reference to its Management

Abstract

Background: The aim and objective of our study was to evaluate demographic pattern, various clinical findings, laboratory investigations and different treatment modalities of hepatic abscess. Introduction: Hepatic abscess is a pus-filled mass or lesion in the liver that can arise from liver injury or an intra-abdominal infection spread from the portal circulation. Hepatic abscesses are of various types depending on the aetiology and may be of 2 major types Pyogenic or Parasitic in origin. Hepatic abscesses are a major issue in tropical countries like India, frequently leading to serious consequences and posing difficulties in diagnosis and treatment. Early diagnosis and prompt treatment now improves the prognosis of the disease. Material and Methods: This was a prospective observational study where 35 patients having proven liver abscess admitted in surgery ward from March 2023 to Feb 2024 are included. A predesigned proforma was used to collect data and all data collected were analyzed statistically. Results: Amoebic hepatic abscesses were more common than pyogenic hepatic abscesses. Hepatic abscesses were more common in male than female with sex ratio of 7.7:1 and majority of patients belong to low socioeconomic status (71.4%). Hepatic abscesses were more common in age group of 31-40 years. Alcoholism (68.6%) and diabetes (14.3%) were the most common predisposing factors. Out of 7 aspirate culture positive, 6 (85.7%) were E. Coli and 1 (14.3%) was Klebsiella. Most of the patient (≥80%) showed > 50% of resolution of abscess at 3rd day of treatment with different treatment modalities. Conclusion: The modern-day ultrasound and other minimally invasive imaging techniques had greatly improved the diagnosis and treatment of hepatic abscess. Conservative management with IV antibiotics and ultrasound guided percutaneous catheter drainage or needle aspiration of an abscess are now the most commonly used treatment modalities.