Volume : VII, Issue : IV, April - 2017

A CLINICO PATHOLOGICAL STUDY AND MANAGEMENT OF RUPTURED LIVER ABSCESS – ORIGINAL ARTICLE

Dr. Saripalli Ammaji, Dr. Akkidas. Suvarchala

Abstract :

 INTRODUCTION:  Liver abscess is a common condition in India. India has 2nd highest incidence of liver abscess in the world. Liver abscesses are caused by bacterial, parasitic or fungal infection. Pyogenic abscesses account for three quarters of hepatic abscess in developed countries. While amoebic liver abscess cause two third of liver abscess in developing countries.AIMS AND OBJECTIVES:To analyse Age and Sex incidence, duration of onset,symptomatology,signs, laboratory investigations, microbiology, chest x–ray and ultrasonographic findings, treatment, complications, in patients of ruptured  liver abscess managed by laparotomy. MATERIALS AND METHODS: A prospective study of forty patients with ruptured liver abscess  was carried out for two years from October 20014 – october 2016. RESULTS:Age and Sex incidence: 95% of patients were male and 5% were female.Age of the patients included in this study varied from 20–70 years. The mean age was 45 years.

Analysis of symptoms:Pain abdomen was the commonest symptom occurring in 40/40 (100%).Fever was the next common symptom in this study (39/40) 97.5%. Analysis of Signs:Abdominal tenderness was elicited in 40/40 (100%) of the cases Fever defined as temperature > 38.50c (101oF) was present in 97.5% (39/40) of the cases.Signs of peritonitis were observed in 39/40(97.5%) at presentation except in a patient who presented with abscess pointing onto parietal wall and later developed peritonitis, while being investigated and found to have ruptured left lobe abscess .Alcoholism in cases of liver abscess:All  male  patients  (38/38)    in  this  study  were  alcoholics. All  these  patients  had  history  of  consuming  alcohol  for  more  than  3  years.Pus Culture Analysis:Out of the total 40 cases included in this study, all cases were subjected to laporotomy and peritoneal toilet. Out of these 40 cases, 32/40 cases had ‘Anchovy sauce’ appearance of the pus and pus revealed no growth giving this a percentage of 80% where no growth was obtained. Organisms were isolated  in 8/40 (20%) of these cases of which E.coli was isolated in 6/40 (15%) of cases and Klebsiella was isolated in 2/40 (5%) of the cases.Utrasound  Abdomen Findings of Liver Abscess: USG abdomen was done in all cases. Solitary abscess was observed in 29/40 (72.5%) of cases while multiple abscess were noted in 11/40 (27.5%) of the cases. Isolated right lobe abscess were seen in 29/40 (72.5%) of cases and left lobe abscesses

were seen in 6/40 (15%) of cases. Both lobe involvement was seen in 5/40 (12.5%) of cases.22 (55%) patients had   hepatomegaly. Mortality Rate: Number of deaths in this study are 2 (5%).CONCLUSION:Liver abscesses occurred most commonly between 30–50 years. Males were affected more than females. Pain abdomen

and fever are the most consistent  symptoms. Alkaline phosphatase is the most consistently elevated  liver function test in cases of liver abscess. Liver abscess usually presented as a solitary abscess most commonly in the right lobe of liver.Intraperitoneal rupture, pleural or pericardial rupture, septicemia, death are the complications that can occur.     

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Article: Download PDF   DOI : 10.36106/ijar  

Cite This Article:

DR. SARIPALLI AMMAJI, DR.AKKIDAS. SUVARCHALA, A CLINICO PATHOLOGICAL STUDY AND MANAGEMENT OF RUPTURED LIVER ABSCESS – ORIGINAL ARTICLE, INDIAN JOURNAL OF APPLIED RESEARCH : Volume‾7 | Issue‾4 | April-2017


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