The experience in a series 182 cases of liver abscess, 108 casess of amebic and 74 cases of pyogenic abscess, seen at the military hospital have been reviwed and studied to obtain a better understanding of the incidence, etiology, pathogenesis, diagnostic. problem, effective therapy, morbidity and mortality of these cases for nine years from Aug. 1965 to July. 1974. Hepatic abscess is an often fatal, but, fortunately rare :clinical problem. two distinct pathogens, pyogenic . bacteria and Entameba histolytica, are responsible for most liver_ abscess in the Korea. Early diagnosis and adequate treatment for the liver abscess and its sources are the most effective means´ of reducing mortality. Intraheptic abscess result either from portal bacteremia or biliary tract disease hepatic trauma general septicemia with bacteria seeding via the hepatic artery or amebiasis.
1. Incidence of liver abscess was approximately, amebic in 59.3% and pyogenic in 40.7%
2. Age and sex incidence of the liver abscess revealed greater prevalence in male of 4th decade (about 37.4%)
3. The location of the liver abscess demonstrated predomience of right lobe of the liver, amebic in 48. 1%, and pyogenic in 42%, involvement and the higher incidence of single abscess over multiple one them.
4. The chief complaints in order of frequency were fever, chill, abdominal pain(R.U.Q. Pain) hepatomegaly, and jaundice.
5. The liver function tests were so helpful in the, diagnosis such as increased alkaline phosphatase(50%), increased B.S.P. retention rate(18%), reversed total serum protein(24%) and jaundice (26%0).
6. The most common organisms in pyogenic liver abscess were E-coli in 28.2% and staphylococcus in 12.6%.
7. The most important advantages of ´liver scanning is highly helpful in early diagnosis of the liver abscess, and can be easily determined possible the decide the therapeutic approach.
8. The complications of the liver abscess were a secondary infection in amebic abscess, pleural effusicn(9.2%), hepatobrcnchial fistula(8.9%), and pericarditis (0.9%).
9. The overall mortality of the liver abscess was 1.8% of amebic abscess, and 6.8% of pyogenic abscess among the treated cases.
|