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Liver abscess in adults: ten years experience in a UK centre

Liver abscess in adults: ten years experience in a UK centre
Liver abscess in adults: ten years experience in a UK centre

Background: the epidemiology and management of liver abscess (LA) have evolved over time.

Aim: to examine our experience over 10 years in a UK teaching centre.

Design: retrospective review of patient records.

Methods: we reviewed the records of all patients aged >16 years discharged from Royal Hallamshire Hospital with a diagnosis of LA between April 1988 and December 1999.

Results: there were 69 patients with LA (65 pyogenic, 4 amoebic), giving a crude annual incidence rate of 2.3/100,000/year (18.15/100,000 hospital admissions). Median age was 64 years. Single lesions were found in 41 patients, multiple lesions in 28. Pre-admission, patients were symptomatic for a median 14 days, with the most common symptoms and signs being fever and abdominal pain/tenderness. Pathogens were identified in 74% and predisposing aetiology in 92% of those undergoing investigation. Spread of infection to the liver via the portal venous system was the commonest route of infection (46%), most frequently in patients aged >/=60 years (p=0.019). Abdominal ultrasound (US) was diagnostic for LA in >90% of cases. Treatment with anti-microbial therapy plus interventional radiology was optimal. The case fatality rate was 12.3%, mainly from associated underlying pathology.

Discussion: LA is commonly associated with underlying gastrointestinal pathology. Seeking out this underlying aetiology is an integral part of management. We recommend US as the first-line diagnostic tool with guided intervention plus antibiotic(s) as first-line treatment. Prognosis depends chiefly on the underlying pathology.

Adolescent, Adult, Age Distribution, Aged, Aged, 80 and over, Female, Hospitalization, Humans, Liver Abscess, Male, Middle Aged, Retrospective Studies, United Kingdom, Journal Article
1460-2725
797-802
Mohsen, A H
9d6389a3-1607-4300-9839-a9914ff2b6ee
Green, S T
1075a760-2a75-443c-96c7-194d0d90ede8
Read, R C
b5caca7b-0063-438a-b703-7ecbb6fc2b51
McKendrick, M W
91cf7c85-c506-466c-a04f-2d9e2c60a2b7
Mohsen, A H
9d6389a3-1607-4300-9839-a9914ff2b6ee
Green, S T
1075a760-2a75-443c-96c7-194d0d90ede8
Read, R C
b5caca7b-0063-438a-b703-7ecbb6fc2b51
McKendrick, M W
91cf7c85-c506-466c-a04f-2d9e2c60a2b7

Mohsen, A H, Green, S T, Read, R C and McKendrick, M W (2002) Liver abscess in adults: ten years experience in a UK centre. QJM: An International Journal of Medicine, 95 (12), 797-802. (doi:10.1093/qjmed/95.12.797).

Record type: Article

Abstract

Background: the epidemiology and management of liver abscess (LA) have evolved over time.

Aim: to examine our experience over 10 years in a UK teaching centre.

Design: retrospective review of patient records.

Methods: we reviewed the records of all patients aged >16 years discharged from Royal Hallamshire Hospital with a diagnosis of LA between April 1988 and December 1999.

Results: there were 69 patients with LA (65 pyogenic, 4 amoebic), giving a crude annual incidence rate of 2.3/100,000/year (18.15/100,000 hospital admissions). Median age was 64 years. Single lesions were found in 41 patients, multiple lesions in 28. Pre-admission, patients were symptomatic for a median 14 days, with the most common symptoms and signs being fever and abdominal pain/tenderness. Pathogens were identified in 74% and predisposing aetiology in 92% of those undergoing investigation. Spread of infection to the liver via the portal venous system was the commonest route of infection (46%), most frequently in patients aged >/=60 years (p=0.019). Abdominal ultrasound (US) was diagnostic for LA in >90% of cases. Treatment with anti-microbial therapy plus interventional radiology was optimal. The case fatality rate was 12.3%, mainly from associated underlying pathology.

Discussion: LA is commonly associated with underlying gastrointestinal pathology. Seeking out this underlying aetiology is an integral part of management. We recommend US as the first-line diagnostic tool with guided intervention plus antibiotic(s) as first-line treatment. Prognosis depends chiefly on the underlying pathology.

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More information

Accepted/In Press date: 19 August 2002
Published date: 1 December 2002
Keywords: Adolescent, Adult, Age Distribution, Aged, Aged, 80 and over, Female, Hospitalization, Humans, Liver Abscess, Male, Middle Aged, Retrospective Studies, United Kingdom, Journal Article

Identifiers

Local EPrints ID: 416556
URI: http://eprints.soton.ac.uk/id/eprint/416556
ISSN: 1460-2725
PURE UUID: 7e44e95e-3b3a-4827-8e57-fea564be57d3
ORCID for S T Green: ORCID iD orcid.org/0000-0003-1760-3679
ORCID for R C Read: ORCID iD orcid.org/0000-0002-4297-6728

Catalogue record

Date deposited: 21 Dec 2017 17:30
Last modified: 10 Nov 2021 03:30

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Contributors

Author: A H Mohsen
Author: S T Green ORCID iD
Author: R C Read ORCID iD
Author: M W McKendrick

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