This study is based on clinical analysis of 89 patients with hepatic abscess who were undergone drainage operation at the Department of Surgery, Chonnam University Hospital during the past 6 year period from July 1966 to June 1972.
The results were summarized as follows:
1 The incidence of liver abscess was 3.1 per cent of 2,868 patients admitted to the Dept. of surgery and 4.35 per cent of 2, 047 total abdominal surgery cases during the same period.
2. Of 89 cases of the liver abscess, 53 cases or 59.6 per cent were amebic abscess and 36 cases or 4.04 per cent pyogenic abscess.
3. There was predominance of male with a ratio of 4 males to 1 female, and the peak incidence of age came in the 4th decade in both types of liver abscess.
4. Acute onset was more frequently observed in the pyogenic abscess than in the amebic abscess. The history of amebic infection was obtained in 47.2 per cent of the 53 amebic liver abscesses, and in the pyogenic abscess 58.3 per cent of the 36 cases had predisposing conditions of pyogenic infection.
5. The commonest clinical manifestations in order of frequency were right hypochondrial pain, local tenderness, fever, hepatomegaly and weight loss in both types of the liver abscess.
6. In majority of cases, the liver functions were mildly disturbed in general.
7. Roentgenographic findings of the chest were showed abnormal in 80.8 per cent of cases with elevation of the right hemidiaphragm being the most frequent abnormal finding (48.3%).
8. The liver abscess was more commonly located in the right lobe (85.4%) than in the left lobe (7.9%). In 6.7% of cases both lobes were involved. A solitary abscess was observed in nearly 11(92.5%) of the amebic abscess, but in the pyogenic abscess multiple abscesses were more commonly seen than solitary abscess (59.8% to 40.2%).
9 of 53 amebic abscesses E. histolytica was found in time pus in 5 cases and only 3 cases had cysts in their stool. The positive cultures were obtained in 25 cases or 69.4 per cent of the 36 pyogenic abscesses. Of the organisms recovered Escherichia species occurred with the greatest frequency(36.4%).
10. The incidence of complication was 18.9 per cent in the amebic and 30.6 per cent in the pyogenic abscesses respectively.
11. The over-all mortality rate was 12.3 per cent of 89 cases. The chief causes of death were septicemia, hepatic coma and postoperative pulmonary complications.
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