A Cross Sectional Study to Assess Clinical Profile of Patients with Liver Abscess in Tertiary Care Centre at Central Rajasthan

Abstract

Introduction: A liver abscess is infective disease of liver parenchyma having collection of purulent material that can develop as a consequence of injury to the hepatic tissue or via portal vein from any source of infection within abdominal cavity. Mostly liver abscess are either due to amoebic infection or pyogenic bacterial infection but in some cases, etiologies like fungal, tubercular or sometimes mixed infections is also seen.

Material and Methods: This present cross-sectional study was carried out by recruiting 137 patients diagnosed of having liver abscess at medical OPD at JLN Hospital, Ajmer during the year December 2019 – June 2021. All the patients with confirmed liver abscess were included in this study. Patients age below 18 years, critically ill patient (Including patients having ruptured liver abscess at the time of presentation and requiring surgical intervention), Pregnancy and GI Malignancy

Results: 137 liver abscess patients were studied and males from lower middle class with a mean age of 38.41±8.81 years were more affected. Biochemical, serological, stool test, radiological and Mantoux test were performed and the mean alkaline phosphatase, GGT, SGOT, SGPT, bilirubin (Total/Direct/Indirect) and PT/INR were found to be raised.

Discussion: Right lobe of liver abscess was solitary. Right side pleural effusion followed by elevation of right hemidiaphragm was the abnormality diagnosed through X-ray. The survival rate was higher either with percutaneous needle drainage or pigtail drainage. E.coli followed by group A beta hemolytic streptococcus, tubercular and fungal etiologies were the most commonly isolated bacteria on pus culture. Blood, urine and stool culture showed positive cultures and some patients with tubercular liver abscess had mantoux test and sputum AFB positive.

Conclusion: Liver abscess is most commonly seen in male from lower middle class mostly in 4^th decade of life who are non-vegetarian and alcoholic. As non-vegetarian diet and alcoholism were found to be the most common risk factors, it is suggestible to avoid/restrict their intake to avoid liver abscess.

Keywords: Liver abscess, usg, Entamoeba histolytica