Abstract

Background: Liver abscess comprises 48% of all the visceral abscesses. Worldwide, approximately 40–50 million people are affected annually with abscesses. It is common in India with second highest incidence due to poor sanitation, overcrowding, and inadequate nutrition.Objectives: The objective of this study is to evaluate patient with liver abscess for etiology, clinical features, and biochemical abnormality.
Materials and Methods: A total of 104 liver abscess patients diagnosed on the basis of ultrasonography were studied in the Department of Medicine, GR Medical College and J A Group of Hospital, Gwalior, from November 2009 to October 2011. All patients are subjected to detailed clinical examination and biochemical testing. On the basis of microbiological study, three groups were formed: Aamoebic liver abscess (ALA) group (n = 39), pyogenic liver abscess (PLA) (n = 28) group and not aspirated Group (n = 37).
Results: Most of the patients belong to ALA group (58.2%) with male preponderance (90.1% in ALA and 60.7% in PLA group) (P = 0.0038). Maximum number of patients of ALA were in <40 years of age group (92.3%) compared to PLA (17.8%) (P = 0.003). Most common comorbidity was cholelithiasis (23.52% in ALA and 37.71% in PLA), and common symptoms were fever (92.30% in ALA and 68.96% in PLA), hypotension (39.2% in PLA and 20.5% in ALA), icterus (42% in ALA and 46% in PLA), and right quadrant tenderness (65.6%). Raised alkaline phosphatases (66% in ALA and 75% in PLA) were the most common liver function test abnormality.Conclusion: PLA was more prevalent in patients with age >40 years, with comorbid condition such as diabetes or cholelithiasis or cholangitis with pulmonary finding, whereas ALA occurs in young male <40 years of age, male accompanied by a history of diarrhea and abdominal pain/tenderness. ALA can be managed without aspiration compared to PLA.