Long-term follow-up of pyogenic liver abscess by ultrasound

Abstract Background/aims To study the morphology of residual abscess in successfully treated pyogenic liver abscess by ultrasound. Methods 116 consecutive patients of liver abscess diagnosed from April 2004 to March 2007 were included in this study. Patients with amebic liver abscess were excluded....

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Bibliographic Details
Published in:European journal of radiology 2010-04, Vol.74 (1), p.195-198
Main Authors: K.C., Sudhamshu, Sharma, Dilip
Format: Article
Language:English
Subjects:
Follow-Up Studies
Humans
Liver Abscess, Pyogenic - diagnostic imaging
Liver Abscess, Pyogenic - therapy
Longitudinal Studies
Pyogenic liver abscess
Radiology
Residual abscess
Ultrasonography
Ultrasound
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Summary:Abstract Background/aims To study the morphology of residual abscess in successfully treated pyogenic liver abscess by ultrasound. Methods 116 consecutive patients of liver abscess diagnosed from April 2004 to March 2007 were included in this study. Patients with amebic liver abscess were excluded. Patients were treated with antibiotics for 6 weeks and when indicated drained percutaneously. Ultrasound scan was repeated after 2 weeks, 1 month, 3 months, 6 months and 12 months of treatment. Thereafter it was repeated every 6 months. Results After exclusion, 102 patients with >150 lesions were studied. Diagnosis was made on the basis of clinical presentation, ultrasound examination and diagnostic aspiration. It was single in 83, double in 12 and more than 2 in seven patients. Size varied from 4.2 cm to 15 cm. Organisms were isolated in 29 patients ( E. coli 10, Kliebsiella sp. 6, S. aureus 5, Pseudomonas aeruginosa 2, Acenetobacter 1 and multiple growth 5) in blood and eight patients ( E. coli 5 and S. aureus 3 and multiple growth 2) in pus. Majority of abscess resolved sonologically after 2–18 weeks of treatment. Healing was delayed in alcoholic and diabetic patients. In eight patients there was residual abscess even after 104 weeks of follow-up. In four patients it healed with calcification. Conclusions Majority of pyogenic liver abscess resolve to normal parenchyma within 18 weeks time. However, some lesions may take longer time to heal even after successful treatment. It should be considered in differential diagnosis of space occupying lesion of the liver in ultrasound and need no therapeutic intervention.
ISSN:0720-048X
1872-7727
DOI:10.1016/j.ejrad.2009.01.017