Liver abscess at the Hadassah University during years 1967-77.

The charts of 36 patients, 27 males and 9 females, with liver abscess diagnosed at the Hadassah University Hospital between 1967-1977 were reviewed. The patients ranged in age from two months to 80 years and 25 patients (69%) were older than 40 years. The diagnosis was initially suggested by liver scan in 18 patients (50%), and was first made at autopsy in six (17%). The time-lapse between the onset of illness and diagnosis ranged from one day to 13 months, with a bimodal distribution. Large solitary abscesses were diagnosed later than small multiple abscesses. Ten patients (28%) were admitted with fever as the only sign of illness; specific signs and laboratory evidence of liver involvement often occurred late in the course of the disease. In 15 patients (42%), the etiology was regarded as amebic. In patients with pyogenic abscesses, the most commonly isolated organisms belonged to the normal bowel flora and biliary tract disease was present in 62% (13/21) of these patients. The overall mortality rate was 31%. This survey stresses the need for an increased awareness of the subtle presentation of liver abscess.