This, study is based on clinical analysis of 296 patients with liver abscess who were undergone drainage operation at the Department of Surgery, Chonnam National University Hospital during the past 16 year period from January 1960 to December 1976.
Among 296 cases of the liver abscess, 168 cases (56.7%) were amebic abscess and 128 cases {43.3%) were pyogenic abscess.
In both groups, male outnumbered female in a 4 : 1 ratio and the peak age incidence came, in the 4th decade. The history of amebic infection was obtained in 45.2 percent of the 168 amebic liver abscess, and in the pyogenic abscess 53. 1 percent of the 128 cases had predisposing condi-tion of pyogenic, infection.
The most common clinical manifestations were pain and tenderness over right upper quadrant, hepatomegaly, fever and chills in both groups. Acute onset was more frequently observed in the pyogenic abscess. In majority of cases, the liver functions were mildly disturbed in general. Chest X-ray findings showed abnormal in 79.7 percent of cases. The elevation of the right hemidiaphragm was the most frequent abnormal findings (43.2%).
Liver -scanning showed cold area suggestive of liver abscess in 62 cases of 65 liver abscess (95.4%). Of 168 amebic abscess E. histolytica was found in the pus in 11.9 percent and 9.5 percent had cysts in their stool., The positive culture were obtained in 67.9% percent of the 128 pyogenic abscess. Of the organisms recovered Escherichia species occurred with the greatest frequency (34%).
The liver abscess was more commonly located in the right lobe (82.8%) than in the left lobe (7.9%). In 6.7 percent of cases both lobes were involved. A solitary abscess was observed in nearly all (92.3%) of the amebic abscess, but in the pyogenic abscess multiple abscess were more commonly seen than solitary abscess (53.9% to 46.1). The incidence of complication was 13.6 percent in the amebic abscess and 28.9 percent in the pyogenic abscess. The overall mortality rate was 8.7 percent of 296 cases. The chief causes of death were septicemia, hepatic coma and postoperative pulmonary complications.
|