Liver abscess in the tropics: an experience from Jammu.

OBJECTIVE

To study the various types of liver abscesses. This prospective study was conducted over a period of one year, from November 2011 to October 2012, at the Department of General Surgery in Acharya Shri Chander College of Medical Sciences and Hospital Sidhra, Jammu.

MATERIALS AND METHODS

The patients in this study were admitted from the emergency wing, and from indoor and outdoor departments of surgery and medicine over a period of one year (November 2011 to October 2012) to the Department of General Surgery in Acharya Shri Chander College of Medical Sciences and Hospital Sidhra, Jammu. Patients of all age groups and both genders who presented with clinical suspicion of liver abscess, or had already been diagnosed, were included in the study. A definitive diagnosis of liver abscess was made based on compatible clinical features, ultrasonography and aspiration or drainage of pus. Diagnostic criteria for the various types of abscesses were as follows: Amoebic abscess: demonstration of Entamoeba histolytica trophozoites in aspirated pus. Pyogenic abscess: positive cultures of blood or aspirated pus. If both of the above sets of criteria were satisfied, the abscess was considered to be of mixed aetiology. Tuberculous abscess was diagnosed by identifying acid-fast bacilli in aspirated material and polymerase chain reaction. The abscess was classified as indeterminate if none of the above criteria were satisfied.

RESULTS

The majority of patients in our study had amoebic liver abscesses (73.33%). Escherichia coli and Klebsiella were the most common organisms cultured from the pyogenic abscesses. The majority of patients with amoebic liver abscesses were treated with drug therapy alone, whereas all pyogenic liver abscesses required some form of drainage.