Sixty-four consecutive cases of hepatic abscess diagnosed over a 6-year period and all treated by ultrasound-guided percutaneous needle aspiration and systemic antibiotics were retrospectively reviewed to ascertain factors influencing the outcome in these patients. The 64 patients had in total 101 liver abscesses which averaged 4.7 cm in diameter. Two patients (3.1%) required surgery for associated biliary tract disease. Five patients (7.8%) died from septicaemia and/or serious condition or malignancy. The remaining 57 patients (89.1%) were successfully treated 45 cases (70.3%) showed fully-resolved abscess/es after a mean period of 69.9 days after initial aspiration; 12 patients (18.8%) showed markedly-shrunken abscess cavity size over an average of 30.7 days and all were asymptomatic on discharge from hospital.No correlation was demonstrated between number of abscesses and successful patient recovery 42 of 46 patients (91.3%) with solitary hepatic abscess recovered, 6 of 8 patients (75.0%) with 2 abscesses and 9 of 10 patients (90.0%) with more than 2 abscesses were successfully treated. No correlation was detected between abscess size and number of aspirations required, majority of abscesses (73.3%) requiring no more than two aspirations irrespective of their sizes. Of the 57 patients cured, no significant correlation between abscess size and degree of abscess healing was evident. Our results demonstrate the effectiveness of percutaneous needle aspiration and it should be considered a first-line treatment in the management of liver abscess, irrespective of their number and sizes.
Liver abscess traditionally has been treated by open surgical drainage, mortality rates being as high as 80% to 100% if left untreated. However, with the advent of modern non-invasive imaging techniques, percutaneous techniques performed under imaging guidance have, over the recent years, become increasingly acceptable as a suitable alternative to open surgical drainage.
This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.