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Large Solitary Pyogenic Liver Abscesses: A Review of Their Management at a Tertiary Care Hospital

Background and objective Liver abscesses are one of the common surgical diseases to be treated as an emergency in any tertiary care hospital in India. The formation of abscesses in the liver is still a major problem and associated with significant morbidity in developing countries. We come across al...

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Autores principales: Prasad, Divya, Ahmad, Manzoor, Katyal, Sachin, Thakral, Ajay K, Husain, Musharraf, Mohsin, Mohammad
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9008598/
https://www.ncbi.nlm.nih.gov/pubmed/35433141
http://dx.doi.org/10.7759/cureus.23170
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author Prasad, Divya
Ahmad, Manzoor
Katyal, Sachin
Thakral, Ajay K
Husain, Musharraf
Mohsin, Mohammad
author_facet Prasad, Divya
Ahmad, Manzoor
Katyal, Sachin
Thakral, Ajay K
Husain, Musharraf
Mohsin, Mohammad
author_sort Prasad, Divya
collection PubMed
description Background and objective Liver abscesses are one of the common surgical diseases to be treated as an emergency in any tertiary care hospital in India. The formation of abscesses in the liver is still a major problem and associated with significant morbidity in developing countries. We come across all types of liver abscesses, such as amoebic (most common), pyogenic, mixed, and occasionally fungal. There have been several studies on the percutaneous modality of treatment for pyogenic liver abscesses. Most of the studies suggest that percutaneous catheter drainage (PCD) offers a better approach than aspirations for treating pyogenic liver abscesses. However, a few recent studies suggest that percutaneous aspiration leads to equally good results when compared to percutaneous drainage. In this study, we aimed to review the management of solitary large pyogenic liver abscesses and to assess the effectiveness of ultrasonography (USG)-guided aspiration in the procedure.  Methods A retrospective study was carried out at the Department of General Surgery of our institute. In this study, a total of 27 patients treated for solitary pyogenic liver abscess were included. All patients with a large liver abscess greater than 5 cm without the features of frank peritonitis were included. These patients were followed up regularly for six months. Results The single-attempt USG-guided aspiration was successful in 70.3% of patients. Repeat USG-guided aspiration was performed in 18.5% of patients. In 7.4% of patients, a USG-guided percutaneous pigtail catheter was placed. And only 3.7% of cases required exploratory laparotomy.  Conclusion Based on our findings, USG-guided aspiration is a fairly efficient method for treating a large solitary pyogenic abscess with acceptable results, shorter hospital stays, and minimal complications.
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spelling pubmed-90085982022-04-14 Large Solitary Pyogenic Liver Abscesses: A Review of Their Management at a Tertiary Care Hospital Prasad, Divya Ahmad, Manzoor Katyal, Sachin Thakral, Ajay K Husain, Musharraf Mohsin, Mohammad Cureus General Surgery Background and objective Liver abscesses are one of the common surgical diseases to be treated as an emergency in any tertiary care hospital in India. The formation of abscesses in the liver is still a major problem and associated with significant morbidity in developing countries. We come across all types of liver abscesses, such as amoebic (most common), pyogenic, mixed, and occasionally fungal. There have been several studies on the percutaneous modality of treatment for pyogenic liver abscesses. Most of the studies suggest that percutaneous catheter drainage (PCD) offers a better approach than aspirations for treating pyogenic liver abscesses. However, a few recent studies suggest that percutaneous aspiration leads to equally good results when compared to percutaneous drainage. In this study, we aimed to review the management of solitary large pyogenic liver abscesses and to assess the effectiveness of ultrasonography (USG)-guided aspiration in the procedure.  Methods A retrospective study was carried out at the Department of General Surgery of our institute. In this study, a total of 27 patients treated for solitary pyogenic liver abscess were included. All patients with a large liver abscess greater than 5 cm without the features of frank peritonitis were included. These patients were followed up regularly for six months. Results The single-attempt USG-guided aspiration was successful in 70.3% of patients. Repeat USG-guided aspiration was performed in 18.5% of patients. In 7.4% of patients, a USG-guided percutaneous pigtail catheter was placed. And only 3.7% of cases required exploratory laparotomy.  Conclusion Based on our findings, USG-guided aspiration is a fairly efficient method for treating a large solitary pyogenic abscess with acceptable results, shorter hospital stays, and minimal complications. Cureus 2022-03-15 /pmc/articles/PMC9008598/ /pubmed/35433141 http://dx.doi.org/10.7759/cureus.23170 Text en Copyright © 2022, Prasad et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle General Surgery
Prasad, Divya
Ahmad, Manzoor
Katyal, Sachin
Thakral, Ajay K
Husain, Musharraf
Mohsin, Mohammad
Large Solitary Pyogenic Liver Abscesses: A Review of Their Management at a Tertiary Care Hospital
title Large Solitary Pyogenic Liver Abscesses: A Review of Their Management at a Tertiary Care Hospital
title_full Large Solitary Pyogenic Liver Abscesses: A Review of Their Management at a Tertiary Care Hospital
title_fullStr Large Solitary Pyogenic Liver Abscesses: A Review of Their Management at a Tertiary Care Hospital
title_full_unstemmed Large Solitary Pyogenic Liver Abscesses: A Review of Their Management at a Tertiary Care Hospital
title_short Large Solitary Pyogenic Liver Abscesses: A Review of Their Management at a Tertiary Care Hospital
title_sort large solitary pyogenic liver abscesses: a review of their management at a tertiary care hospital
topic General Surgery
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9008598/
https://www.ncbi.nlm.nih.gov/pubmed/35433141
http://dx.doi.org/10.7759/cureus.23170
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