PYOGENIC LIVER-ABSCESS - REPORT OF 50 CAS ES

During the last years the diagnosis and treatment of pyogenic liver ab scess has changed substantially. The aim of this work is to report a r etrospective analysis of 50 patients aged 24 to 87 years old, that pre sented with a pyogenic liver abscess and were treated in the last 13 y ears. The sensitivity for diagnosis of ultrasound examination, CAT sca n and angiography was 68, 89 and 75% respectively. The origin of the a bscess was detected at the biliary tree in 46% and remained unknown in 38%. Thirty one patients were operated, 13 were subjected to percutan eous drainage and 5 were treated only with antimicrobials. Forty perce nt of patients had a septic complication and 4 (8%) died. Mean hospita l stay was 31 days for operated patients and 21 for the rest. The absc ess recurred in seven patients and two of these had a gallbladder carc inoma. It is concluded that percutaneous drainage is an alternative to surgical treatment that must be accompanied by a careful diagnostic w orkup.