CLINICAL FINDINGS, ETIOLOGY, DIAGNOSIS AN D THERAPY OF LIVER-ABSCESSES

In a retrospective study (1984-1991) we evaluated 56 patients with pyo genic (44 patients) and with amebic (12 patients) liver abscesses. Pat ients with pyogenic liver abscesses usually belong to the older genera tion (70-80 years). Pyogenic abscesses are mainly due to a severe unde rlying disease and patients are in poor general condition. Therapy inc ludes antibiotics and in most cases drainage (nowadays mainly percutan eous; surgical drainage should only be used with a simultaneous intraa bdominal procedure for treatment of the underlying disease). The mean hospitalization time is 33 days. Prognosis is good, the mortality of 1 4% being mainly due to severe underlying disease. This latter can be f ound in 75% of the patients and should be treated electively. In amebi c liver abscesses the patients are much younger (around 30 years). Pat ients are in good general condition and antibiotics alone are sufficie nt for radical treatment. The mean hospitalization time is 16.5 days a nd mortality is zero. Symptoms and clinical signs are the same in both groups: fever, right upper quadrant tenderness, jaundice and hepatome galy. Diagnosis by ultrasonography and/or computed tomography is very reliable. History and serology are reliable for differentiation of the two types. With a correct diagnostic approach and treatment, liver ab scesses are today benign conditions with a low mortality.