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Liver abscess of hydatid origin: Clinical features and results of aggressive treatment
Author(s) -
Manterola Carlos,
Barroso Manuel,
Vial Manuel,
Bustos Luis,
Muñoz Sergio,
Losada Héctor,
Bello Nelson,
Hernández Francisco,
Carrasco Roberto
Publication year - 2003
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1046/j.1445-2197.2003.02354.x
Subject(s) - medicine , liver abscess , perioperative , echinococcosis , surgery , abscess , biliary fistula , cyst , radiology , fistula
Background : Cyst infection and subsequent liver abscess formation are complications of liver echinococcosis. Traditionally, this condition has been treated by simple drainage, a procedure associated with unsatisfactory postoperative evolution. Methods : The present paper examines a series of cases involving infected liver echinococcal cysts. Surgery was performed at the Temuco Regional Hospital after assessment was made of general and liver laboratory parameters, chest X‐ray and abdominal ultrasound were performed and antibiotic treatment was administered. The procedure consisted of surgical drainage, parasite material extirpation and pericystic membrane resection with surrounding healthy liver parenchyma. The morbidity and mortality rate, hospital stay and evidence of recurrent hydatid disease were evaluated. Results : Forty‐nine patients (21 male and 28 female), with a median age of 45 years (range 16–84 years), with infected cysts measuring 14 cm in ultrasonographical diameter (range 5–30 cm) were operated on. In the majority of cases, liver abscesses were located in the right lobe (37 patients, 75.4%) and the most frequent computed tomography scan pattern was heterogeneous (40 patients, 81.6%). The median hospital stay was 5 days, the median follow‐up period was 32 months (range 2–91 months) and perioperative morbidity was 24.4%. Surgical complications were verified in five patients (10.2%) and medical complications occurred in seven cases (14.3%). No recurrence of hydatid disease was observed. Mortality was 2% (one patient). Conclusions : Good results were obtained when hydatid liver abscesses were treated aggressively.