Modern management of pyogenic hepatic abscess: a case series and review of the literature.

Hdl Handle:
http://hdl.handle.net/10147/203255
Title:
Modern management of pyogenic hepatic abscess: a case series and review of the literature.
Authors:
Heneghan, Helen M; Healy, Nuala A; Martin, Sean T; Ryan, Ronan S; Nolan, Niamh; Traynor, Oscar; Waldron, Ronan
Affiliation:
Department of Surgery, Mayo General Hospital, Castlebar, Mayo, Ireland., helenheneghan@hotmail.com.
Citation:
BMC Res Notes. 2011 Mar 24;4:80.
Journal:
BMC research notes
Issue Date:
31-Jan-2012
URI:
http://hdl.handle.net/10147/203255
DOI:
10.1186/1756-0500-4-80
PubMed ID:
21435221
Abstract:
BACKGROUND: Pyogenic hepatic abscesses are relatively rare, though untreated are uniformly fatal. A recent paradigm shift in the management of liver abscesses, facilitated by advances in diagnostic and interventional radiology, has decreased mortality rates. The aim of this study was to review our experience in managing pyogenic liver abscess, review the literature in this field, and propose guidelines to aid in the current management of this complex disease. METHODS: Demographic and clinical details of all patients admitted to a single institution with liver abscess over a 5 year period were reviewed. Clinical presentation, aetiology, diagnostic work-up, treatment, morbidity and mortality data were collated. RESULTS: Over a 5 year period 11 patients presented to a single institution with pyogenic hepatic abscess (55% males, mean age 60.3 years). Common clinical features at presentation were non-specific constitutional symptoms and signs. Aetiology was predominantly gallstones (45%) or diverticular disease (27%). In addition to empiric antimicrobial therapy, all patients underwent radiologically guided percutaneous drainage of the liver abscess at diagnosis and only 2 patients required surgical intervention, including one 16-year old female who underwent hemi-hepatectomy for a complex and rare Actinomycotic abscess. There were no mortalities after minimum follow-up of one year. CONCLUSIONS: Pyogenic liver abscesses are uncommon, and mortality has decreased over the last two decades. Antimicrobial therapy and radiological intervention form the mainstay of modern treatment. Surgical intervention should be considered for patients with large, complex, septated or multiple abscesses, underlying disease or in whom percutaneous drainage has failed.
Language:
eng
ISSN:
1756-0500 (Electronic); 1756-0500 (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorHeneghan, Helen Men_GB
dc.contributor.authorHealy, Nuala Aen_GB
dc.contributor.authorMartin, Sean Ten_GB
dc.contributor.authorRyan, Ronan Sen_GB
dc.contributor.authorNolan, Niamhen_GB
dc.contributor.authorTraynor, Oscaren_GB
dc.contributor.authorWaldron, Ronanen_GB
dc.date.accessioned2012-01-31T15:55:26Z-
dc.date.available2012-01-31T15:55:26Z-
dc.date.issued2012-01-31T15:55:26Z-
dc.identifier.citationBMC Res Notes. 2011 Mar 24;4:80.en_GB
dc.identifier.issn1756-0500 (Electronic)en_GB
dc.identifier.issn1756-0500 (Linking)en_GB
dc.identifier.pmid21435221en_GB
dc.identifier.doi10.1186/1756-0500-4-80en_GB
dc.identifier.urihttp://hdl.handle.net/10147/203255-
dc.description.abstractBACKGROUND: Pyogenic hepatic abscesses are relatively rare, though untreated are uniformly fatal. A recent paradigm shift in the management of liver abscesses, facilitated by advances in diagnostic and interventional radiology, has decreased mortality rates. The aim of this study was to review our experience in managing pyogenic liver abscess, review the literature in this field, and propose guidelines to aid in the current management of this complex disease. METHODS: Demographic and clinical details of all patients admitted to a single institution with liver abscess over a 5 year period were reviewed. Clinical presentation, aetiology, diagnostic work-up, treatment, morbidity and mortality data were collated. RESULTS: Over a 5 year period 11 patients presented to a single institution with pyogenic hepatic abscess (55% males, mean age 60.3 years). Common clinical features at presentation were non-specific constitutional symptoms and signs. Aetiology was predominantly gallstones (45%) or diverticular disease (27%). In addition to empiric antimicrobial therapy, all patients underwent radiologically guided percutaneous drainage of the liver abscess at diagnosis and only 2 patients required surgical intervention, including one 16-year old female who underwent hemi-hepatectomy for a complex and rare Actinomycotic abscess. There were no mortalities after minimum follow-up of one year. CONCLUSIONS: Pyogenic liver abscesses are uncommon, and mortality has decreased over the last two decades. Antimicrobial therapy and radiological intervention form the mainstay of modern treatment. Surgical intervention should be considered for patients with large, complex, septated or multiple abscesses, underlying disease or in whom percutaneous drainage has failed.en_GB
dc.language.isoengen_GB
dc.titleModern management of pyogenic hepatic abscess: a case series and review of the literature.en_GB
dc.contributor.departmentDepartment of Surgery, Mayo General Hospital, Castlebar, Mayo, Ireland., helenheneghan@hotmail.com.en_GB
dc.identifier.journalBMC research notesen_GB
dc.description.provinceConnacht-

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