PRESENTATION AND MANAGEMENT OF LIVER ABSCESS

Objective: To study the presentation of liver abscess and its management with especial reference to role of ultrasound guided percutaneous aspiration.Material and Methods: This study was conducted in all the four medical units of Khyber Teaching Hospital, Peshawar, from 1st June 2001 to 31st march 2003. The diagnosis was confirmed by ultra sonogram but in selected cases CT scan was also performed. A total of 100 cases were included in the study.Results: 80% patients were males, 84% were from 15 to 50 years. Fever was the most common presentation i.e. 98%, followed by pain right hypochondrium in 96%, anorexia in 84%, hepatomegaly in 78%, and point tenderness in right lower chest in 68%. 64% abscesses were located in right lobe and 77% were single. 30% patients responded to medicines only, 54% patients were subjected to ultrasound guided percutaneous aspiration of abscesses followed by appropriate medical treatment. Only 16% were referred to surgical units for open drainage.Conclusion: It can be concluded from the above study that amoebic liver abscesses most commonly affect males, who are usually under 50 years of age, fever being the most common presenting feature followed by pain right hypochondrium. Amoebic liver abscesses usually occur in right lobe of liver, most often present as single lesion. Usually it is managed by medicines alone or by percutaneous aspiration under ultrasound guidance. Ultrasound guided percutaneous aspiration in a safe, economical, easy way of management of liver abscess.