A Clinical Study of Hepatic Abscess with Focus on Its Management (Code-T053)

Introduction: Hepatic abscess is a pus-filled mass or lesion in the liver, often resulting from liver injury or an intra-abdominal infection spreading through the portal circulation. Hepatic abscesses can be of pyogenic or parasitic origin, with varying etiologies. They pose a major healthcare challenge in tropical countries like India, often leading to serious consequences and complications in diagnosis and treatment. Early diagnosis and timely treatment are crucial for improving prognosis.

Aims and Objectives: This study aims to evaluate the clinical presentation, diagnostic methods, and management strategies for hepatic abscesses, focusing on their outcomes and complications.

Material and Methods: This prospective observational study included 35 patients diagnosed with hepatic abscess, admitted to the surgery ward between March 2023 and February 2024. Data were collected using a predesigned proforma and analyzed statistically.

Results: Amoebic hepatic abscesses were more prevalent than pyogenic ones. Hepatic abscesses were more common in males, with a male-to-female ratio of 7.7:1, and the majority of patients were from low socioeconomic backgrounds (71.4%). The most common age group affected was 31-40 years. Alcoholism (68.6%) and diabetes (14.3%) were the primary predisposing factors. Among the 7 aspirate culture-positive cases, 6 (85.7%) grew E. coli and 1 (14.3%) grew Klebsiella. More than 80% of patients showed over 50% resolution of the abscess by the third day of treatment with various therapeutic interventions.

Conclusion: Advancements in ultrasound and minimally invasive imaging techniques have significantly improved the diagnosis and management of hepatic abscesses. Conservative management, including intravenous antibiotics and ultrasound-guided percutaneous drainage or needle aspiration, are the most commonly used treatment approaches today.

Keywords: Hepatic abscess, Clinical management, Diagnostic imaging, Percutaneous drainage, Antibiotic therapy, Surgical intervention.