This paper is only available as a PDF. To read, Please Download here.
Abstract
Clinical, bacteriologic and therapeutic aspects of 53 patients with hepatic abscess
seen from 1961 to 1973 are reviewed. Of these abscesses, 50 were pyogenic and 3 amebic
in etiology. The mortality was 63 per cent; the greatest number of cases (38) and
the greatest mortality (79 per cent) occurred in patients over 50 years of age. Thirty-five
patients had macroscopic abscesses; in the remaining 18 the abscesses were microscopic
in size. The most common causes of pyogenic macroscopic abscess were biliary tract
infection (11 cases), direct extension from contiguous sites of infection (8 cases)
and nonpenetrating trauma (5 cases). The causes of microscopic abscesses were biliary
tract infection (9 cases), systemic bacteremia (8 cases) and pylephlebitis (1 case).
Although the diagnosis was often obscure with nonspecific clinical and laboratory
findings, the hepatic scintiscan and abdominal angiography were positive in all cases
in which the abscesses were greater than 1 cm in diameter. Bacteria of bowel origin
(particularly Escherichia coli, other Enterobacteriaceae and anaerobes) were the common
etiologic agents. Staphylococcus aureus was implicated predominantly in children with
bacteremia. Prolonged antibiotic administration and aggressive surgical drainage are
the cornerstones of effective therapy.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to The American Journal of MedicineAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Pyogenic abscess of the liver. II. An analysis of 47 cases with review of the literature.Am J Surg. 1938; 40: 292
- Liver abscess: a review of 85 cases.N Engl J Med. 1934; 211: 21
- Changing trends in the casuistics of hepatic abscess.Am J Med. 1960; 28: 943
- Surgery of the Liver.in: Schiff L Diseases of the Liver. 3rd ed. J. B. Lippincott Co, Philadelphia1969: 875
- Pyogenic liver abscess.in: Mayo Clinic Proc. 48. 1973: 349
- Cryptogenic liver abscess.Lancet. 1960; 1: 355
- Pylephlebitis and liver abscess following appendicitis.Surg Gynecol Obstet. 1926; 42: 510
- Pyogenic liver abscess.Gut. 1969; 10: 389
- Abscesses of the liver: surgical considerations.Arch Surg. 1970; 101: 258
- Liver abscess.Postgrad Med. 1961; 30: 11
- Intrahepatic abscess.Am Surg. 1969; 35: 144
- The changing clinical pattern of hepatic abscess.Arch Surg. 1972; 104: 465
- Diagnosis and treatment of intrahepatic abscess.Am Surg. 1967; 33: 820
- Hepatic pyemia.N Engl J Med. 1965; 272: 551
- Hepatic abscess: factors determining its localization.Arch Pathol. 1948; 45: 41
- Pyogenic abscess of the liver.Gut. 1961; 2: 53
- Granulomatous abscess of the liver of pyogenic origin.Am J Pathol. 1931; 7: 259
- Liver abscess.JAMA. 1940; 114: 2369
- Pyogenic liver abscess: changing patterns in approach.Am J Surg. 1968; 115: 63
- Hepatic abscess: current concepts in diagnosis and management.Arch Surg. 1967; 94: 353
- Surgery of liver abscesses: use of newer techniques to reduce mortality.Arch Surg. 1964; 88: 602
- Portal pyaemia.Br J Surg. 1958; 45: 357
- Liver sepsis.Br J Surg. 1964; 51: 363
- Diverticulitis and diverticulosis with a report on a rare complication.Med J Aust. 1954; 1: 470
- Pyogenic liver abscess probably secondary to sigmoid diverticulitis: report of two cases.Gastroenterology. 1960; 38: 262
- Acquired diverticula of the sigmoid flexure, considered especially in relation to secondary pathological processes and their clinical symptoms.Lancet. 1908; 1: 843
- Acquired diverticula of the sigmoid flexure, considered especially in relation to secondary pathological processes and their clinical symptoms.Lancet. 1908; 1: 928
- Acquired suppurative diverticulitis with pylephlebitis and metastatic suppuration in the liver.Surg Gynecol Obstet. 1926; 42: 540
- Pylephlebitis and liver abscess.Am J Surg. 1954; 88: 411
- Pyogenic infection of the liver secondary to infection in the portal drainage area.Br Med J. 1964; 2: 1558
- The diagnosis of pyogenic liver abscess.Lancet. 1954; 2: 1093
- Surgical management of hepatic abscess.Am J Surg. 1969; 118: 317
- Solitary pyogenic liver abscess.Br Med J. 1964; 2: 613
- Suppurative pancreatitis with associated liver abscess.Ann Surg. 1945; 121: 853
- Pylephlebitis.Bull J Hopkins Hosp. 1960; 106: 65
- Solitary hepatic abscess following perirectal abscess.Milit Med. 1966; 131: 1328
- Pyogenic liver abscess.Can Med Assoc J. 1955; 73: 133
- Portal pyaemia with recovery.Lancet. 1944; 1: 151
- Pylephlebitis of extraportal origin; report of a case with review of the literature.Am J Med Sci. 1937; 193: 690
- Portal bacteremia in ulcerative colitis.Lancet. 1958; 1: 1206
- Liver disease in Crohn's colitis; a study of 21 consecutive patients having colectomy.Ann Intern Med. 1971; 74: 518
- The Management of Colitis.National Medical Book Co, New York1935
- Liver abscess complicating regional enteritis: report of two cases.Gastroenterology. 1965; 49: 548
- The association of multiple hepatic abscesses and chronic ulcerative colitis.Med Clin North Am. 1933; 16: 1427
- Treatment of nonamebic (pyogenic) liver abscess.Am J Gastroenterol. 1969; 51: 410
- Multiple liver abscesses complicating nonspecific chronic ulcerative colitis: report of a case.Gastroenterology. 1952; 20: 166
- Suppurative pylephlebitis with bacteremia in chronic ulcerative colitis.Ann Intern Med. 1950; 33: 211
- Regional enteritis complicated by pylephlebitis and multiple liver abscesses.Am J Med. 1949; 7: 838
- Pyogenic hepatic abscess.Arch Surg. 1968; 97: 40
- Acute obstructive cholangitis: a distinct clinical syndrome.Ann Surg. 1959; 150: 299
- Acute obstructive suppurative cholangitis.Surg Gynecol Obstet. 1961; 113: 265
- Acute Suppurative cholangitis. Experience with 15 consecutive cases.Arch Surg. 1967; 94: 460
- Acute obstructive suppurative cholangitis.Ann Surg. 1969; 169: 272
- Pyogenic hepatic abscesses in infancy and childhood.J Pediatr. 1969; 74: 763
- Angiography of liver abscess in granulomatous disease of childhood.Am J Roentgenol Radium Ther Nucl Med. 1970; 108: 628
- Chronic granulomatous disease of childhood.in: Good RA Fisher DW Immunobiology. 1st ed. Sinauer Associates, Stamford, Conn1971: 55
- Liver scanning.JAMA. 1967; 200: 630
- Radioisotope photoscan of liver in differential diagnosis of upper abdominal disease: review of 232 cases.Ann Surg. 1966; 163: 685
- Visualization of filling defects in a liver phantom containing Tc-99m, Hg-197, I-131, or Au-198 using a rectilinear scanner or scintillation camera.Am J Roentgenol Radium Ther Nucl Med. 1967; 101: 551
- Scintillation scanning in the diagnosis of hepatic abscess in children.J Pediatr. 1970; 77: 211
- The liver abscess: rose bengal I-131 hepatic photoscan in diagnosis and management.JAMA. 1964; 187: 708
- The liver photoscan in the recognition and management of abdominal masses.Henry Ford Hosp Med Bull. 1966; 14: 85
- Radioisotope scanning in the diagnosis of liver abscess.Am J Surg. 1970; 119: 330
- Increased specificity of liver scanning with the use of 67 Gallium citrate.N Engl J Med. 1972; 286: 1323
- Gallium-67 for localization of septic lesions.Ann Intern Med. 1973; 79: 403
- Effects of intrahepatic and extrahepatic infection on liver function.Br Med J. 1966; 1: 382
- Hepatitis associated with systemic infections.in: Schiff L Diseases of the Liver. 3rd ed. J. B. Lippincott Co, Philadelphia1969: 602
- Radiology in diagnosis and control of surgical treatment of subphrenic and liver abscesses.in: 3rd ed. Proc Roy Soc Med. 63. 1970: 319
- The roentgenological diagnosis of abscess on the concave surface of the liver.Am J Roentgenol Radium Ther Nucl Med. 1936; 35: 65
- Gas-containing pyogenic intrahepatic abscesses.Radiology. 1970; 94: 613
- Roentgenographic findings in accidental ligation of the hepatic artery: case report.Radiology. 1965; 85: 56
- The significance of air in the biliary system and liver.Surg Gynecol Obstet. 1969; 128: 49
- A clinical comparison of amebic and pyogenic abscess of the liver in sixty-six patients.Am J Med. 1972; 53: 323
- Solitary abscess of liver.Ann Surg. 1906; 44: 217
- The single pyogenic liver abscess: a study of 24 cases.Surg Gynecol Obstet. 1934; 59: 31
- Primary abscess in the liver due to anaerobic nonhemolytic streptococcus.Ann Surg. 1942; 116: 217
- Pyogenic liver abscess due to microaerophilic streptococci.Ann Surg. 1967; 165: 362
- Anaerobic pyogenic liver abscess.Ann Intern Med. 1972; 77: 629
- Pyogenic liver abscess: a review with a case report of a solitary abscess caused by Salmonella enteritidis.Gastroenterology. 1952; 21: 291
Article info
Publication history
Accepted:
March 12,
1974
Footnotes
☆This study was supported in part by Training Grant 5-T01-AI00215-10 from the U.S. Public Health Service.
Identification
Copyright
© 1974 Published by Elsevier Inc.
