[Pyogenic liver abscesses--diagnostic and surgical problems].

The authors discuss the clinical-diagnostic and surgical problems in the treatment of the pyogenic hepatic abscesses. Eight patients, undergone the operation during the second period after 1971, were out of 18 patients operated (1951--1983) were analyzed in details. An inexplicable predomination of males and affection of all age groups is reported. The abscesses are cryptogenic in 2 of the patients, after operation of the hepaticbiliary system--in 2, after gastric operation--in 3, after abdominal trauma--in 1. The possible way of penetration of the infection is discussed. In was established that it parallel with the characteristic clinical picture and biochemical deviations, typical for the septic process, a definite diagnosis is made via echography and computer tomography, supported by scintigraphy, angiography, punching of the abscess, inspection graphy of the hepatic region. The treatment is difficult and complex: Antibiotic, generally tonizising and surgical. The choice of the operative approach denends on the localization, number of the abscesses and character (pyogenic, amebic, etc). The therapeutic tasks are discussed as well as the operation methods applied, punch-aspiration including. The risk of complications and lethality remain high, three patients were discharged healthy, with improvement--2, deceased--3 (sepsis, stress-ulcer, pulmonary embolism).