European Journal of Molecular & Clinical Medicine

Abstract

Background&Method: Laparoscopic drainage of liver abscesses in combination with
systemic antibiotics is a safe and useful alternative in all patients who require surgical
drainage following failed medical or percutaneous drainage treatment and in those with
large abscesses. Operative techniques have started on intravenous antibiotics and the
laparoscopic procedure was performed under general anaesthesia with endotracheal
intubation. The patient was placed in the reverse Trendelenburg position and a
pneumoperitoneum was created with a veres needle to a pressure of 09-12 mm Hg.
Result: Pain in the right upper abdomen, fever and hepatomegaly were the most common
presenting features in 99.5% of patient. History of alcoholic intake leading to liver abscess
was 36%, while 36.84% of cases presented with mid jaundice. History of past dysentery was
34.21%. In the study by Abuabara etal(1982), the most common symptom of ALA was
Right upper abdominal pain (94%), fever (77%) and hepatomegaly(54%). In the study
by Charles etal(1989), the most common symptom was fever(70-80%), hepatomegaly
(56-65%), right upper abdominal pain (50%). Hematological investigation were carried
out in all patients the mean hemoglobin value was 10.1 gm/dL with a range of 5.0 gm% to
14.5 gm%. Leucocytosis, predominantly polymorphonuclear was observed, the mean
leucocyte count was 13,500 cells/cumm with a range of 5,500-32,000 cells/cumm. The
serum bilirubin was elevated in 60 (101) cases, the values ranging from 1.8-17 mg% with a
mean of 3.39 mg%. Hypoproteinemia was observed in majority of cases,the values ranging
from 4.8-8.9 mg/dl with a mean value of 6.47mg/dl.
Conclusion: In summary , the most common presenting features were Fever,
Hepatomegaly, with males in the age group 41-50 being mostly affected. Right lobe
involvement (singly) with raised dome of diaphragm were seen most commonly on
radiological investigations. PLA should be treated with broad spectrum antibiotics and
in abscesses larger than 2.5 cm, aspiration should be done. Operative intervention is
required for intra-abdominal infections that are seeding the liver abscess.