Chiang Tung-Ying, Huang Yung-Ning, Weng Yu-Chieh, Liu Xiang-Bo, Zeng Chun-Guang, Yang Guang-Ming, Lee Jung-Chieh, Liu Peng-Xiang, Yang Chih-Kai, Cheng Pei-Ting, Hsieh Hui-Shan, Chen Wei-Ting, Lu Yang-Bor
Department of Digestive Disease Xiamen Chang Gung Hospital Xiamen China.
Department of Radiology Xiamen Chang Gung Hospital Xiamen China.
JGH Open. 2023 Jun 22;7(6):419-423. doi: 10.1002/jgh3.12913. eCollection 2023 Jun.
A pyogenic liver abscess (PLA) is an infectious disease with high in-hospital mortality. It has no specific symptoms and is difficult to be diagnosed early in the emergency department. Ultrasound is commonly used to detect PLA lesions of PLA, but its sensitivity can be affected by lesion size, location, and clinician experience. Therefore, early diagnosis and prompt treatment (especially abscess drainage) are crucial for better patient outcomes and should be prioritized by clinical physicians.
We conducted a retrospective study to compare the effect of early and late (i.e., receiving CT scanning within 48 h and >48 h after admission) adoption of nonenhanced computed tomography (CT) scanning regarding the hospitalization days and interval between admission and drainage of patients with PLA.
This study included 76 hospitalized patients with PLA in the Department of Digestive Disease of Xiamen Chang Gung Hospital in China who underwent CT examinations from 2014 to 2021. We conducted CT scans on 56 patients within 48 h of admission and on 20 patients more than 48 h after admission. The early CT group had a significantly shorter hospitalization length compared with the late CT group (15.0 days vs. 20.5 days; = 0.035). Besides, the median time to initiate drainage after admission was also significantly shorter in the early CT group than in the late CT group (1.0 days vs. 4.5 days; < 0.001).
Early CT scanning within 48 h of admission may aid in early PLA diagnosis and benefit disease recovery, as revealed by our findings.
化脓性肝脓肿（PLA）是一种院内死亡率较高的感染性疾病。它没有特异性症状，在急诊科很难早期诊断。超声常用于检测PLA的病变，但其敏感性会受到病变大小、位置和临床医生经验的影响。因此，早期诊断和及时治疗（尤其是脓肿引流）对于改善患者预后至关重要，临床医生应予以优先考虑。
我们进行了一项回顾性研究，比较早期和晚期（即入院后48小时内和入院后>48小时接受CT扫描）采用非增强计算机断层扫描（CT）对PLA患者住院天数和入院至引流间隔的影响。
本研究纳入了2014年至2021年在中国厦门长庚医院消化内科住院的76例PLA患者，这些患者均接受了CT检查。我们对56例患者在入院后48小时内进行了CT扫描，对20例患者在入院后48小时以上进行了CT扫描。早期CT组的住院时间明显短于晚期CT组（15.0天对20.5天；=0.035）。此外，早期CT组入院后开始引流的中位时间也明显短于晚期CT组（1.0天对4.5天；<0.001）。
我们的研究结果表明，入院后48小时内进行早期CT扫描可能有助于PLA的早期诊断并有利于疾病恢复。
