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KMID : 0371319700120050045
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Journal of the Korean Surgical Society
1970 Volume.12 No. 5 p.45 ~ p.53
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Clinical Observation on 75 Cases of the liver Abscess
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정충섭/Jung, J.S.
김수용/김세환/김영우/Kim, S.Y./Kim, S.H./Kim, Y.W.
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Abstract
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This study is based on the analysis of 75 patiens with liver abscess admitted te the Wonju Union
Christian Hospital during the period from 1963 to 1968 and a review of the literature.
Among 75 cases of liver abscess, 40(53.3%) were amebic and 25(33.3%)were pyogenic and 10
(13.3%) were mixed type.
There were predominance of male sex in groups showing the male to female ratio of 9;1 in amebic,
7;1 in pyogenic, and 10l0 in mixed type.
Liver abscess occurred most frequently during adult life with highest incidence in the 2nd decade
in amebic abscess, 3rd decade in pyogenic abscess and 2nd & 4th decades in mixed type.
The average duration from onset to admission was 20 days.
More acute onset was frequently observed in pyogenic & mixed abscess than in amebic abscess.
The most common clinical manisfestations were abdominal pain, fever, chills, hepatomegaly and hepatic
tenderness.
Revewing past history, the amebic dysentery was most common in amebic abscess. Liver laceration,
appendicitis, biliary tract infection, bacillary dysentery were present in pyogenic abscess. The
appendicitis was found in 7.5% of amebic and 4% of pyogenic abscess respectively.
Roentgenography was useful diagnostic procedure in liver abscess.
The elevation of the Rt diaphragm, the Rt pleural reaction, and the atelectasis were noted most
frequently.
Positive roentgenologic signs on admission were present in 67.5% of amebic abscess, and 64% of
pyogenic abscess and 90% of mixed type.
Proloned BSP, elevation of serum bilirubin and elevation of serum alkaline phosphatase were
frequently seen in these cases.
The pyogenic & mixed abscess were caused by Staphylococci(37.4%) and Escherchia-colie(31.4%)
The incidence of post-op complication was 22.7% in amebic, 21% in pyogenic and 16.5% in
mixed type.
The post-op complications were 5 cases of pyothorax, preural effusiion, subphrenic-abscess, shock,
& volvulus in amebic abscess and 4 cases of pleural effusion, subphrenic-abscess, bleeding, & hepatic
coma in pyogenic abscess and 1 case of pyothorax in mixed type.
Most of the patient (65%) were treated by surgical drainage with antibiotics or amebicides.
The remnant of patients(35%) were treated by medical treatment only or needle aspiration with
medical treatment.
The most frequent locition of the abscess was in the Rt lobe(85%) and very small numbrse in
Lt lobe(6.4%). In 8.5% of cases, the abscess was found in both lobe. The mortality rate was
7.5% in amebic and 16% in pyogenic and 10% in mixed type.
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KEYWORD
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