Author(s): J. L. Kumawat1, H. S. Udawat2, F. S. Mehta3, P. K. Bhatnagar4, Pankaj Saxena5, Rita Saxena6
Untreated, pyogenic liver abscess remains uniformly fatal. With timely administration of antibiotics and drainage procedures, mortality currently occurs in 5-30% of cases. The most common causes of death include sepsis, multi organ failure, and hepatic failure. (1) During the period of 4 years (2010-2014), 61 patients with liver abscess more than 5cms size underwent percutaneous catheter drainage under sonography guidance at Geetanjali Medical Collage and Hospital, Udaipur, Rajasthan. 48(78.68%) had solitary abscess while 10(16.39%) cases had double & 3(4.91%) had triple abscesses. 36(59%) had right lobe involvement, 15(24.59%) had left lobe involvement and 10(16.39%) had involvement of both the lobes. 30(49.98%) were in the age group of 41 to 70 yrs. 51 (83.60%) were males and 10(16.39%) were females. 40 (66.66%) were rural and 21(34.42%) were from urban population. All patients presented with pain right Hypochondrium, 46(75.40%) presented with high grade pyrexia, 26(42.62%) had nausea and vomiting, 10(16.39%) had loss of appetite and 10(16.39%) had associated respiratory discomfort. On exam all patients showed Hepatomegaly. Most cases had pyrexia, tachycardia and were toxic. Inv revealed low haemoglobin, raised total leucocyte count, deranged liver function tests. Ultrasonography revealed liver abscess and CT scan abdomen was confirmatory. (Fig. 1) All patients were treated with anti- biotics and PCNL Malicot catheter of various size 12F-14F was introduced in these patients using the Seldinger technique. The volume of pus drained ranged from 200 to 1500 ml while the period of catheter drainage was from 4day to 14 days. In 40(66.66%) patients, pus was sterile on culture (Amoebic) while 21(34.42%) cases had Bacterial positive culture. There was no mortility associated with this procedure.