Profile of liver abscess patients admitted in a tertiary care hospital

Background and Aim: Early diagnosis and prompt intervention improve the survival and outcome in liver abscess patients. The objective of the study is to assess the clinical profile and management of liver abscess in the patients requiring admission in a tertiary care hospital. Methods: This is a retrospective cross-sectional study carried out from January 2021 to April 2022. A total of 80 patients admitted with diagnosis of liver abscess were accessed. Results: The mean age of patients was 42.7 years with 90% males. The mean duration between symptom onset and presentation was 10 days. There was a strong correlation with alcohol addiction and diabetes mellitus. Most common presenting complaint was pain abdomen (94.3%) followed by fever (88.5%), vomiting (27.5%) and abdominal distension (10.1%). Other minor presentation include jaundice, diarrhea, bleeding per rectum, shortness of breath, pancreatitis. Examination revealed tender hepatomegaly in (80.5%) while ascites, pleural effusion and icterus were present in (31.25%), (37.5%) and (20%) cases respectively. Imaging revealed rupture abscess in right pleural cavity (31.25%), peritoneum (25%), subcapsular (12.5%) and stomach (1.25%). On evaluation, mean TLC was 21860/cumm, serum albumin was (2.2 gm/dL), Bilirubin was (2.1mg/dl), AST (55), ALT (68) ALP (510), PT/INR (18/1.8) while serum creatinine was raised in (16.2%) of which 5% required Hemodialysis. The abscess was predominantly right lobe (70%) and solitary (56.8%) with mean volume of 408.6 mL. Left lobe abscess in (12.5%) while both lobes were involved in (17.5%) of patients. Etiology-80 % were amebic (with 30% having secondary bacterial infection), 17.5% pyogenic (E coli >Klebsiella>Staphalococcus) and 1.3% tubercular and 1.3% actinomycotic. Pigtail drainage in 90% with percutaneous needle aspiration from other small abscesses (73.9%) Intercostal ain was placed in 33% and peritoneal ain in 24%, surgical intervention for rupture in 3.75% patients. Mortality rate was 2.5%. Conclusion: Early diagnosis and prompt intervention would lead to reduction in morbidity mortality and hospital stay.