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Pyogenic Abscesses of the Liver


Authors: V. Třeška;  T. Skalický;  V. Liška;  H. Mírka;  D. Šmíd;  M. Vachtová
Authors‘ workplace: Radiodiagnostická klinika FN a LF UK, přednosta: doc. MUDr. B. Kreuzberg, CSc. ;  Chirurgická klinika FN a LF UK v Plzni, přednosta: prof. MUDr. V. Třeška, DrSc.
Published in: Rozhl. Chir., 2007, roč. 86, č. 6, s. 284-287.
Category: Monothematic special - Original

Overview

Pyogenic abscesses of the liver represent a serious nosologic unit with high morbidity and mortality rates. Their diagnostics is based on ultrasonography, computer tomography or MRI, or positrone emission tomography. The principal treatment procedure includes percutaneous draining of the abscess cavity under the ultrasound or CT control. The authors present a group of 83 subjects hospitalized from 2000 to 2006 for pyogenic abscesses of the liver. Obstruction of the bile ducts, acute cholecystitis and resections of the liver or pancreas for malignancies were recorded as the commonest causes of the abscesses. Percutaneous drainage was the treatment method of choice in 67.5% of the subjects and it included management of the causative factors and administration of antibiotics. The hospitalization period was affected by the following factors: septic conditions (p < 0.04), ALT levels (p < 0.003) – cut off 3.0 mkat/l, the abscess diameter, which may have required reoperation, (p < 0,05), diabetes mellitus (p < 0.05) and septic conditions (p < 0.001). The need for re-hospitalization due to a relaps of the pyogenic abscess of the liver correlated significantly with the following: a number (> 2) of abscesses (p < 0.04), C- reactive protein levels (p < 0.005) – cut off > 100 mg/l and septic conditions (p < 0.007). Furthermore, significat correlation was detected between the mortality rates and sepsis (p < 0.05).

Key words:
pyogenic abscess of the liver – ethiopathogenesis – treatment – morbidity and mortality rates factors


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