SOLITARY AND MULTIPLE PYOGENIC LIVER-ABSCESSES - CHARACTERISTICS OF THE PATIENTS AND EFFICACY OF PERCUTANEOUS DRAINAGE

Objectives: Although percutaneous drainage has emerged as one of the f irst line of therapies for pyogenic liver abscesses, the presence of m ultiple abscesses may warrant surgical drainage, which remains controv ersial in the literature, We studied whether the multiplicity of the l esions influences the outcome of the treatment. Methods: Ultrasonograp hy-guided percutaneous drainage was carried out in 48 patients with py ogenic liver abscesses, The abscesses were solitary in 38 patients and multiple (two to seven lesions) in 10 patients, Clinical characterist ics and the efficacy of the treatment were compared between these two groups, Results: Biliary diseases and malignancies were more frequentl y observed in the solitary cases than multiple cases, A past history o f surgery for cholelithiasis was seen exclusively in the multiple case s, E. coli was more frequently cultured from the abscesses in the mult iple cases, Three of the multiple cases required more than a single ca theter, All of the multiple cases and 36 of the 38 solitary cases were successfully treated, Two patients died of biliary peritonitis as a c omplication of the procedure, and three died of other underlining dise ases, Conclusion: Ultrasonography-guided percutaneous drainage is effe ctive even in patients with multiple pyogenic liver abscesses by addin g catheters to obtain sufficient drainage.