Skip to main content
Erschienen in: Indian Journal of Surgery 5/2012

01.10.2012 | Original Article

A Prospective Series Case Study of Pyogenic Liver Abscess: Recent Trands in Etiology and Management

verfasst von: Dhaval O. Mangukiya, Jitendra R. Darshan, Vijay K. Kanani, Saurabh T. Gupta

Erschienen in: Indian Journal of Surgery | Ausgabe 5/2012

Einloggen, um Zugang zu erhalten

Abstract

Our study aims to review the literature on the management of pyogenic liver abscess, focusing on the choice of drainage. A case series of our experience with clinicopathological correlation is presented to highlight the indication and outcome of each modality of drainage. Intravenous antibiotic is the first line, and mainstay, of treatment. Drainage is necessary for large abscesses, equal to or larger than 5 cm in size, to facilitate resolution. While percutaneous drainage is appropriate as first-line surgical treatment in most cases, open surgical drainage is prudent in cases of rupture, multiloculation, associated biliary, or intra-abdominal pathology. Percutaneous drainage may help to optimize clinical condition prior to surgery. Nevertheless, in current good clinical practices, the choice of therapy needs to be individualized according to patient’s clinical status and abscess factors. They are complementary in the management of liver abscesses.
Literatur
2.
Zurück zum Zitat Oschner A, DeBaker M, Murray S (1938) Pyogenic abscess of liver. II. An analysis of forty seven cases with review of literature. Am J Surg 40:292–319CrossRef Oschner A, DeBaker M, Murray S (1938) Pyogenic abscess of liver. II. An analysis of forty seven cases with review of literature. Am J Surg 40:292–319CrossRef
3.
Zurück zum Zitat Mehnaz A, Mohsin S (1991) Liver abscess in children not an uncommon problem. JPMA 273–275 Mehnaz A, Mohsin S (1991) Liver abscess in children not an uncommon problem. JPMA 273–275
4.
Zurück zum Zitat Miedema BW, Dineen P (1984) The diagnosis and treatment of pyogenic liver abscess. Ann Surg 200(3):328–334PubMedCrossRef Miedema BW, Dineen P (1984) The diagnosis and treatment of pyogenic liver abscess. Ann Surg 200(3):328–334PubMedCrossRef
5.
Zurück zum Zitat Bugti QA, Baloch MA, Wadood AU, Mulghani AH, Azeem B, Ahmed J (2005) Pyogenic liver abscess: demographic, clinical, radiological and bacteriological characteristics and management strategies. GJMS 3:1 Bugti QA, Baloch MA, Wadood AU, Mulghani AH, Azeem B, Ahmed J (2005) Pyogenic liver abscess: demographic, clinical, radiological and bacteriological characteristics and management strategies. GJMS 3:1
6.
Zurück zum Zitat Norman DC, Yoshikawa TT (1984) Intra-abdominal infection: diagnosis and treatment in the elderly patient. Gerontology 30:327–328PubMedCrossRef Norman DC, Yoshikawa TT (1984) Intra-abdominal infection: diagnosis and treatment in the elderly patient. Gerontology 30:327–328PubMedCrossRef
7.
Zurück zum Zitat McFadzean AJS, Chang KPS, Wong CC (1953) Solitary pyogenic abscess of the liver treated by closed aspiration and antibiotics: a report of 14 consecutive cases with recovery. Br J Surg 41:141–152PubMedCrossRef McFadzean AJS, Chang KPS, Wong CC (1953) Solitary pyogenic abscess of the liver treated by closed aspiration and antibiotics: a report of 14 consecutive cases with recovery. Br J Surg 41:141–152PubMedCrossRef
8.
Zurück zum Zitat Stain SC, Yellin AK, Donovan AJ et al (1991) Pyogenic liver abscess: modern treatment. Arch Surg 126:991–996PubMedCrossRef Stain SC, Yellin AK, Donovan AJ et al (1991) Pyogenic liver abscess: modern treatment. Arch Surg 126:991–996PubMedCrossRef
9.
Zurück zum Zitat Lee KT, Sheen PC, Chen JS et al (1991) Pyogenic liver abscess—multivariate analysis of risk factors. World J Surg 15:372–377PubMedCrossRef Lee KT, Sheen PC, Chen JS et al (1991) Pyogenic liver abscess—multivariate analysis of risk factors. World J Surg 15:372–377PubMedCrossRef
10.
Zurück zum Zitat Rubin RH, Swartz MN, Malt R (1974) Hepatic abscess: changes in clinical, bacteriological and therapeutic aspects. Am J Med 57:601–610PubMedCrossRef Rubin RH, Swartz MN, Malt R (1974) Hepatic abscess: changes in clinical, bacteriological and therapeutic aspects. Am J Med 57:601–610PubMedCrossRef
11.
Zurück zum Zitat Bourne WA (1954) The diagnosis of pyogenic liver abscess. Lancet 2:1093–1094CrossRef Bourne WA (1954) The diagnosis of pyogenic liver abscess. Lancet 2:1093–1094CrossRef
12.
Zurück zum Zitat Bergamini TM, Larson GM, Malangoni MA et al (1987) Liver abscess: review of a 12-year experience. Am Surg 53:596–599PubMed Bergamini TM, Larson GM, Malangoni MA et al (1987) Liver abscess: review of a 12-year experience. Am Surg 53:596–599PubMed
13.
Zurück zum Zitat Chiu CT, Lin DY, Wu CS et al (1990) A clinical study of pyogenic liver abscess. J Formos Med Assoc 86:571–576 Chiu CT, Lin DY, Wu CS et al (1990) A clinical study of pyogenic liver abscess. J Formos Med Assoc 86:571–576
14.
Zurück zum Zitat Yang CC, Chen CY, Lin XZ et al (1993) Pyogenic liver abscess in Tiwan: emphasis on gas-forming liver abscess in diabetics. Am J Gastroenterol 88:1911–1915PubMed Yang CC, Chen CY, Lin XZ et al (1993) Pyogenic liver abscess in Tiwan: emphasis on gas-forming liver abscess in diabetics. Am J Gastroenterol 88:1911–1915PubMed
15.
Zurück zum Zitat Balci NC, Semelka RC, Noone TC et al (1999) Pyogenic hepatic abscesses MRI findings on T-1 and T2 weighted and serial gadolinium-enhanced gradient echo images. J MRI 9:285–290 Balci NC, Semelka RC, Noone TC et al (1999) Pyogenic hepatic abscesses MRI findings on T-1 and T2 weighted and serial gadolinium-enhanced gradient echo images. J MRI 9:285–290
16.
Zurück zum Zitat Seeto RK, Rockey DC (1996) Pyogenic liver abscess, changing, etiology, management and outcome. Medicine (Baltimore) 75:99–113CrossRef Seeto RK, Rockey DC (1996) Pyogenic liver abscess, changing, etiology, management and outcome. Medicine (Baltimore) 75:99–113CrossRef
17.
Zurück zum Zitat Lok KH, Li KF, Li KK, Szeto ML (2008) Pyogenic liver abscess: clinical profile, microbiological characteristics, and management in a Hong Kong hospital. J Microbial Immunol Inf 41:483–490 Lok KH, Li KF, Li KK, Szeto ML (2008) Pyogenic liver abscess: clinical profile, microbiological characteristics, and management in a Hong Kong hospital. J Microbial Immunol Inf 41:483–490
18.
Zurück zum Zitat Ch Yu S, Hg Lo R, Kan PS, Metreweli C (1997) Pyogenic liver abscess treatment with needle aspiration. Clinical Radiol 52:912–916CrossRef Ch Yu S, Hg Lo R, Kan PS, Metreweli C (1997) Pyogenic liver abscess treatment with needle aspiration. Clinical Radiol 52:912–916CrossRef
19.
Zurück zum Zitat Zerem E, Hadzic A (2007) Sonographically guided percutaneous catheter drainage versus needle aspiration in the management of pyogenic liver abscess. AJR 189:W138–W142PubMedCrossRef Zerem E, Hadzic A (2007) Sonographically guided percutaneous catheter drainage versus needle aspiration in the management of pyogenic liver abscess. AJR 189:W138–W142PubMedCrossRef
20.
Zurück zum Zitat Razak CL, Gupta S, Jain S et al (1998) Percutaneous treatment of liver abscesses: needle aspiration versus catheter drainage. AJR 170:1035–1039 Razak CL, Gupta S, Jain S et al (1998) Percutaneous treatment of liver abscesses: needle aspiration versus catheter drainage. AJR 170:1035–1039
21.
Zurück zum Zitat Yu SC, Ho SS, Lau WY et al (2004) Treatment of pyogenic liver abscess: prospective randomized comparison of catheter drainage and needle aspiration. Hepatology 39:932–938PubMedCrossRef Yu SC, Ho SS, Lau WY et al (2004) Treatment of pyogenic liver abscess: prospective randomized comparison of catheter drainage and needle aspiration. Hepatology 39:932–938PubMedCrossRef
22.
Zurück zum Zitat Giorgio A, de Stefano G, Di Sarno A et al (2006) Percutaneous needle aspiration of multiple pyogenic abscesses of the liver: 13-year single-center experience. AJR Am J Roentgenol 187(6):1585–1590PubMedCrossRef Giorgio A, de Stefano G, Di Sarno A et al (2006) Percutaneous needle aspiration of multiple pyogenic abscesses of the liver: 13-year single-center experience. AJR Am J Roentgenol 187(6):1585–1590PubMedCrossRef
23.
Zurück zum Zitat Liao WI, Tsai SH, Yu CY, Huang GS, Lin YY, Hsu CW, Hsu HH, Chang WC. Pyogenic liver abscess treated by percutaneous catheter drainage: MDCT measurement for treatment outcome. Eur J Radio. 2011; [Epub ahead of print]. Liao WI, Tsai SH, Yu CY, Huang GS, Lin YY, Hsu CW, Hsu HH, Chang WC. Pyogenic liver abscess treated by percutaneous catheter drainage: MDCT measurement for treatment outcome. Eur J Radio. 2011; [Epub ahead of print].
24.
Zurück zum Zitat Malik AA, Bari SU, Rouf KA, Wani KA (2010) Pyogenic liver abscess: changing patterns in approach. World J Gastrointest Surg 2(12):395–401PubMedCrossRef Malik AA, Bari SU, Rouf KA, Wani KA (2010) Pyogenic liver abscess: changing patterns in approach. World J Gastrointest Surg 2(12):395–401PubMedCrossRef
25.
26.
Zurück zum Zitat Chung DR, Lee SS, Lee HR, Kim HB, Choi HJ, Eom JS et al (2007) Emerging invasive liver abscess caused by K1 serotype Klebsiella pneumoniae in Korea. J Infect 54:578–583PubMedCrossRef Chung DR, Lee SS, Lee HR, Kim HB, Choi HJ, Eom JS et al (2007) Emerging invasive liver abscess caused by K1 serotype Klebsiella pneumoniae in Korea. J Infect 54:578–583PubMedCrossRef
27.
Zurück zum Zitat Chen SC, Huang CC, Tsai SJ et al (2009) Severity of disease as main predictor for mortality in patients with pyogenic liver abscess. Am J Surg 198:164PubMedCrossRef Chen SC, Huang CC, Tsai SJ et al (2009) Severity of disease as main predictor for mortality in patients with pyogenic liver abscess. Am J Surg 198:164PubMedCrossRef
28.
Zurück zum Zitat Lok KH, Li KF, Li KK, Szeto ML (2008) Pyogenic liver abscess: clinical profile, microbiological characteristics, and management in a Hong Kong hospital. J Microbiol Immunol Infect 41:483PubMed Lok KH, Li KF, Li KK, Szeto ML (2008) Pyogenic liver abscess: clinical profile, microbiological characteristics, and management in a Hong Kong hospital. J Microbiol Immunol Infect 41:483PubMed
Metadaten
Titel
A Prospective Series Case Study of Pyogenic Liver Abscess: Recent Trands in Etiology and Management
verfasst von
Dhaval O. Mangukiya
Jitendra R. Darshan
Vijay K. Kanani
Saurabh T. Gupta
Publikationsdatum
01.10.2012
Verlag
Springer-Verlag
Erschienen in
Indian Journal of Surgery / Ausgabe 5/2012
Print ISSN: 0972-2068
Elektronische ISSN: 0973-9793
DOI
https://doi.org/10.1007/s12262-011-0397-0

Weitere Artikel der Ausgabe 5/2012

Indian Journal of Surgery 5/2012 Zur Ausgabe

Review Article

Ischemic Colitis

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

CME: 2 Punkte

Prof. Dr. med. Gregor Antoniadis Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

CME: 2 Punkte

Dr. med. Benjamin Meyknecht, PD Dr. med. Oliver Pieske Das Webinar S2e-Leitlinie „Distale Radiusfraktur“ beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

CME: 2 Punkte

Dr. med. Mihailo Andric
Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.