Pyogenic Liver Abscess: Title and subTitle BreakModern Treatment FREE

Steven C. Stain, MD; Albert E. Yellin, MD; Arthur J. Donovan, MD; Heather W. Brien, MD

[+] Author Affiliations

Accepted for publication May 19, 1991.

Read before the 98th Annual Meeting of the Western Surgical Association, Scottsdale, Ariz, November 13, 1990.

Reprint requests to Department of Surgery, Room 9442, Los Angeles County–University of Southern California Medical Center, 1200 N State St, Los Angeles, CA 90033 (Dr Yellin).

Arch Surg. 1991;126(8):991-996. doi:10.1001/archsurg.1991.01410320077010

Text Size: A A A

Published online

Article

References

Comments

ABSTRACT

ABSTRACT | REFERENCES

• Historically, open surgical drainage has been the treatment of choice for pyogenic liver abscess. The records of 54 patients with pyogenic liver abscess were reviewed to determine whether earlier diagnosis with current imaging tests and definitive treatment with antibiotics, aspiration, or catheter drainage was an effective alternative to open drainage. Twenty-nine patients were treated with broad-spectrum antibiotics and diagnostic aspiration. Twenty-three (79%) recovered uneventfully, and six required catheter or operative drainage. Twenty-three patients (including five who failed aspiration) underwent drainage with percutaneously placed catheters. Nineteen (83%) recovered; four required open surgical drainage. Of seven patients who required open surgical drainage, six recovered. One (2%) of the 54 patients died following failed aspiration and catheter and surgical drainage. Four patients were successfully treated with antibiotics alone without aspiration. These results confirm that pyogenic liver abscess can be successfully treated with broad-spectrum antibiotics and aspiration or percutaneous catheter drainage. Open surgical drainage is reserved for patients in whom treatment fails or who require celiotomy for concurrent disease.

(Arch Surg. 1991;126:991-996)

REFERENCES

ABSTRACT | REFERENCES

Ochsner A, Debakey M, Murray S. Pyogenic liver abscess, II: an analysis of 47 cases with review of the literature . Am J Surg . 1938;;40:292-319.

Bertel CK, Van Heerden JA, Sheedy PF. Treatment of pyogenic hepatic abscesses: surgical vs percutaneous drainage . Arch Surg . 1986;;121:554-558.

Klatchko BA, Schwartz SI. Diagnostic and therapeutic approaches to pyogenic abscess of the liver . Surg Gynecol Obstet . 1989;;168:332-336.

Gyorffey EJ, Frey CF, Silva J, McGahan J. Pyogenic liver abscess: diagnostic and therapeutic strategies . Ann Surg . 1987;;206:699-705.

Bergamini TM, Larson GM, Malangoni MA, Richardson JD. Liver abscess: review of a 12-year experience . Am Surg . 1987;;53:596-599.

Barnes PF, DeCock KM, Reynolds TN, Ralls PW. A comparison of amebic and pyogenic abscesses of the liver . Medicine . 1987;;66:472-483.

Cohen JL, Martin FM, Rossi RL, Schoetz DJ. Liver abscess: the need for complete gastrointestinal evaluation . Arch Surg . 1989;;124:561-564.

Juniper K Jr, Worrell CL, Minshew MC, Roth LS, Cypert H, Lloyd RE. Serologic diagnosis of amebiasis . Am J Trop Med Hyg . 1972;;21:157-168.

Ralls PW, Barnes PF, Radin DR, Colletti PM, Halls J. Sonographic features of amebic and pyogenic liver abscesses: a blinded comparison . Am J Rad . 1987;;149:499-501.

Ochsner A, Debakey M. Amebic hepatitis and hepatic abscess . Surgery . 1943;;13:460-612.

McFadzean AJS, Chang KPS, Wong CC. Solitary pyogenic abscess of the liver treated by closed aspiration and antibiotics: a report of 14 consecutive cases of recovery . Br J Surg . 1953;;41:141-152.

England RA, England MJ. Hong Kong an elective . Boston Med Q . 1964;; 15:64-69.

Pitt. HA. Surgical management of hepatic abscesses . World J Surg . 1990;;14:498-504.

Gerzof SG, Johnson WC, Robbins AH, Nasbeth DC. Intrahepatic pyogenic abscess treatment by percutaneous drainage . Am J Surg . 1985;;149:487-494.

Wong KP. Percutaneous drainage of pyogenic liver abscesses . World J Surg . 1990;;14:492-497.

Donovan AJ, Yellin AE, Ralls PW. Hepatic abscess . World J Surg . 1991;;15:162-169.

Maher JA, Reynolds TB, Yellin AE. Successful medical treatment of pyogenic liver abscess . Gastroenterology . 1979;;77:618-622.

First Page Preview

Figures

Tables

Interactive Graphics

Video

Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal