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LIVER ABSCESS IN WESTERN AUSTRALIA (1974‐1983)
Author(s) -
Levitt M. D.,
Quinlan M. F.,
Sheiner H. J.
Publication year - 1986
Publication title -
australian and new zealand journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.111
H-Index - 51
eISSN - 1445-2197
pISSN - 0004-8682
DOI - 10.1111/j.1445-2197.1986.tb06160.x
Subject(s) - medicine , incidence (geometry) , liver abscess , pyogenic liver abscess , abscess , amoebiasis , serology , amoebic liver abscess , presentation (obstetrics) , surgery , quadrant (abdomen) , pediatrics , immunology , physics , antibody , optics
Over the 10 year period 1974‐1983, 91 cases of liver abscess presented to the major teaching hospitals in Perth, Western Australia. Amoebic liver abscess (ALA) accounted for 37 (or 41%) of these cases, an incidence inflated by Perth's proximity to south‐east Asia where amoebiasis is endemic. This frequent recent history of contact, the availability of sensitive and specific diagnostic serology and a clinical presentation usually suggesting pathology in the right upper quadrant, accounted for the consistently short delay in diagnosis of ALA. There were no deaths from ALA and a low incidence of complications such as secondary infection or rupture into the thorax. On the other hand, pyogenic liver abscess (PLA) commonly presented in a more non‐specific manner and in an older age group, contributing to a long delay in diagnosis. Despite improvements in liver imaging techniques and advances in antibiotic and general supportive therapy, mortality for PLA remains high, 20% in this series. Fatal PLA was associated with multiple abscesses not amenable to drainage, increasing age, delay in diagnosis and the presence of septicaemia.