A study of medical management of liver abscess. | [Biomedica • 2004]

Author(s):

1. Abdul-Karim: Departments of Pharmacology, Medical Unit-1 and Physiology Quaid-e-Azam Medical College, B. V. Hospital, Bahawalpur, Pakistan

2. Amar Haleem: Departments of Pharmacology, Medical Unit-1 and Physiology Quaid-e-Azam Medical College, B. V. Hospital, Bahawalpur, Pakistan

3. Abd-Ul-Qayyum: Departments of Pharmacology, Medical Unit-1 and Physiology Quaid-e-Azam Medical College, B. V. Hospital, Bahawalpur, Pakistan

4. N. U. H. Ansari: Departments of Pharmacology, Medical Unit-1 and Physiology Quaid-e-Azam Medical College, B. V. Hospital, Bahawalpur, Pakistan

5. Shafiq. Iqbal: Departments of Pharmacology, Medical Unit-1 and Physiology Quaid-e-Azam Medical College, B. V. Hospital, Bahawalpur, Pakistan

Abstract:

Liver abscess is a common problem in our country. There are different treatment modalities depending upon site and size of the abscess. This study was conducted on 25 patients. It was a case series study. The patients were evaluated with detailed history, physical examination and investigations. The diagnosis was made ultrasonographically. In amoebic liver abscess metronidazole 800 mg TDS was given whereas in pyogenic liver abscess and in conditions where distinction was not possible, antibiotics used were tripple therapy consisting of ampicillin (500 mg 8 hourly), Gentamycin (80 ing 8 hourly) and metronidazole (800 mg TDS). Percutaneous aspiration was attempted in 12 cases and was successful in 10 cases. In 16 patients (64%) abscess was present in left lobe. In 3 patients (12%) abscess was present in both lobes. Thirteen patients (52%) showed good response to medical treatment alone. Aspiration was attempted in 12 patients and it was successful in 10 (83%). Two cases were referred for surgery. Results of aspiration show that 3 (30%) had pyogenic abscess whereas 7 cases (70%) had amoebic, abscess. Multiple aspirations were done in 2 patients. The clinical features responded quickly within 48 hours to intravenous metronidazole and after 10 days of the same treatment, patients became mostly symptom free e.g. fever, vomiting or pain. The addition of chloroquine worked favourably towards, resolution of abscess without causing any significant side effects. Side effects observed were metallic taste (70%), anorexia, nausea (62%) and vomiting (15%). It was relieved by symptomatic treatment. It is concluded that small abscesses respond well to drug therapy alone. Large abscesses are managed with percutaneous aspiration under ultrasound guidance alongwith medical treatment. Ultrasound guided drainage of large liver abscess, as a primary procedure is very useful. There is very little morbidity and the hospital stay is reduced.

Page(s): 52-55

DOI: DOI not available

Published: Journal: Biomedica, Volume: 20, Issue: 1, Year: 2004

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