Gowtham, K (2020) A Clinicopathologic study and Management Strategies of Liver Abscess. Masters thesis, Kilpauk Medical College, Chennai.
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Abstract
This is a retrospective study of 50 patients admitted in Govt. Kilpauk Medical College Hospital with Liver abscess. The most common age group affected are 40-60 years. The mean age of presentation is 48.18 years. The common mode of presentation is acute (< 10 days). Pain abdomen was the most common presenting symptom present in 100 percent of the cases. Fever was the most consistent symptom present in 88% of cases. Loose stools was present in 12% and anorexia was present in 44% of cases. Hepatomegaly in 34% of the cases and jaundice in 22% of cases was found. Pleural effusion was found in 12% cases. The 88% chesrt x-ray were normal. 88% were alcoholic and duration alcohol intake more than one year. Alcoholism is the most consistent etiological factor for formation of liver abscess. Laboratory investigations were analysed. Leucocytosis in 76%, anaemia in 28%, Blood sugar > 200mgms in 22% of cases, raised urea and creatinine in 16% cases. Alkaline phosphotase is elevated in 36% of cases consistent finding in liver abscess. Raise bilirubin in 24% and prolonged prothrombin in 4% of cases. Raised blood glucose level is seen in 22% of patients. Diabetes is associated the pyogenic liver abscess in this study. Among fifty cases 54% of patients had ‘Anchovy sauce’ appearance of pus and no growth in culture. E.coli in 16% and klebsiella in 24% of cases. Enterobacter in 4% seen. Klebsiella in the most common organism isolated in pyogenic liver abscess. Ultrasonography done in all cases revealed 96 % are solitary and 4% are multiple. Right lobe abscess in 88% cases and left lobe in 8% cases. Out of fifty cases 10% conservative, 8% ultrasound guided aspiration and 82% pigtail aspiration done. Pigtail drainage is the safe and effective method and associated with less recurrence was seen. CONCLUSION: • Liver absecess is a very common problem in India. Incidence is very high in India. • Liver abscess commonly occur in the age group of 40-60 years. Males are most affected in my study. • Most cases present with an acute onset. • Pain abdomen was the most common present in 100% of the cases. The most consistently occurring symptom is fever. • The single most important factor is alcohol consumption. Leucocytosis is seen in most of the cases. • Hypoalbunemia, raised WBC count, alkaline phosphatase level, diabetes. • Prolonged prothrombin time were considered as predictive factors. These factors prolong the hospital stay in present study. • Diabetes associated with liver abscess more frequently. • Liver abscesses are mostly solitary and present in right lobe of liver. • Klebsiella is the most common organism causing pyogenic liver abscess. 54% patients showed no growth in their culture. Ultrasound guided pigtail drainage and aspiration is the less invasive, safe and Effective management of liver abscess. Mean duration of hospital stay is 12.8 days. No recurrence and no complications in present study. Nil mortality in this study.
| Item Type: | Thesis (Masters) |
|---|---|
| Additional Information: | 221711154 |
| Uncontrolled Keywords: | Liver Abscess, Management Strategies, Clinicopathologic study. |
| Subjects: | MEDICAL > General Surgery |
| Depositing User: | Subramani R |
| Date Deposited: | 10 Feb 2021 15:47 |
| Last Modified: | 10 Feb 2021 15:47 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/13987 |
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