CLINICAL CASE STUDY OF LIVER ABSCESS- CONSERVATIVE VERSUS OPERATIVE MANAGEMENT IN 50 CASES

Liver abscesses, both amoebic and pyogenic, continue to be an important cause of morbidity and mortality in tropical countries. India has the 2nd most burden of liver abscess amongst all other countries. [1,2] Hepatic abscesses develop insidiously with fever, sweats, weight loss and no local signs other than painless or slightly tender hepatomegaly. In patients it presents with abrupt onset of fever, nausea, severe abdominal pain and polymorphonucleosis. Amoebic liver abscess occurs in population where Entamoeba histolytica is endemic and it affects right lobe in 80% of cases. Right lobe via Portal vein receives the blood from the caecum, ascending colon and right half of transverse colon, where the amoebic involvement is more common. Liver cells undergo liquefaction necrosis and produces an abscess (Portal Pyemia). Amoebic abscess is approximately 10 times more common in male sex as compared to females. Pyogenic liver abscess can be single or multiple. The right lobe is more than two times affected as compared to left while in 5% cases both lobes of liver are involved.