CLINICOPATHOLOGICAL STUDY AND MANAGEMENT OF LIVER ABSCESS IN A TERTIARY CARE HOSPITAL

Liver abscess is an uncommon but potentially life threatening disease with significant morbidity and mortality. It is more frequent in the tropical regions like Indian subcontinent due to poor sanitary condition and overcrowding. The common etiological agents for LA are E. histolytica (amoebic), bacterial (pyogenic). Out of them Amoebic liver abscess is largely a disease of developing countries like India. There are many risk factors predisposing patients to liver abscess range from diabetes mellitus, cirrhosis and general immune-compromised state, use of proton pump inhibitor medications, gender and age. The aim of the study is to describe the clinical profile, microbial etiology and treatment approaches for the management of liver abscess. This is a prospective observational study conducted at Gandhi hospital, Secunderabad, Telangana, for a period of 6 months; about 60 patients who meet the study criteria were included in the study. The required data was collected from the patient proforma. 60 patients diagnosed with liver abscess were studied over a period of 6 months. There were 83% of patients are males (n = 50) and 17% were females (n = 10). Male to female ratio was 5:1. The age ranges from ranged from 10-90 years, mean age being 49.55 years. Majority of the patients are affected from the age group 51-60 years (26.66%) and 61-70 years (25%). Etiology of abscess was 76.70% amoebic and 23.30 % pyogenic. All the amoebic abscesses are solitary and majority of pyogenic are multiple (78.57%). The abscesses were predominantly in right lobe (70%). Most cases of amoebic etiology are reported from the age group 41-50 years (23.91%), where as pyogenic are reported from age group 61-70 years. The treatment of choice for PLA is a multi modal approach combining broad spectrum antibiotics and aspiration or drainage of abscess cavities. Amoebic liver abscess can be cured by metronidazole therapy without drainage. The key to successful outcome with both the approaches is early diagnosis and institution of appropriate therapy.