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

Hdl Handle:
http://hdl.handle.net/10147/567105
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
Citation:
BMC Research Notes. 2011 Mar 24;4(1):80
Issue Date:
24-Mar-2011
URI:
http://dx.doi.org/10.1186/1756-0500-4-80; http://hdl.handle.net/10147/567105
Abstract:
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:
en
Keywords:
LIVER DISEASE; ABCESSES

Full metadata record

DC FieldValue Language
dc.contributor.authorHeneghan, Helen Men
dc.contributor.authorHealy, Nuala Aen
dc.contributor.authorMartin, Sean Ten
dc.contributor.authorRyan, Ronan Sen
dc.contributor.authorNolan, Niamhen
dc.contributor.authorTraynor, Oscaren
dc.contributor.authorWaldron, Ronanen
dc.date.accessioned2015-08-17T09:08:58Zen
dc.date.available2015-08-17T09:08:58Zen
dc.date.issued2011-03-24en
dc.identifier.citationBMC Research Notes. 2011 Mar 24;4(1):80en
dc.identifier.urihttp://dx.doi.org/10.1186/1756-0500-4-80en
dc.identifier.urihttp://hdl.handle.net/10147/567105en
dc.description.abstractAbstract 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.en
dc.language.isoenen
dc.subjectLIVER DISEASEen
dc.subjectABCESSESen
dc.titleModern management of pyogenic hepatic abscess: a case series and review of the literatureen
dc.language.rfc3066enen
dc.rights.holderHeneghan et al; licensee BioMed Central Ltd.en
dc.date.updated2015-08-14T13:26:01Zen
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