Ruptured liver abscess: Analysis of 50 cases

Background: Liver abscess (pyogenic and amebic) is frequently encountered clinical condition; however, it can result in lethal outcome if there is a delay in diagnosis and treatment. Despite modalities to diagnose the condition early, still ruptured liver abscess presents with a common cause of acute abdomen in surgical emergency. In developing countries, ruptured liver abscess is a common cause of mortality. For contained abscess, nonsurgical options are considered; however, for ruptured liver abscess, surgical intervention is considered necessary. Materials and Methods: This was a retrospective study carried in Safdarjung hospital, New Delhi, between 2015 and 2016. All patients with ruptured liver abscess (clear signs of peritonitis) were included in this study, and those patients having other causes of peritonitis were excluded. A preformed protocol for management was followed for all the patients, and various parameters contributing to the illness and its prognosis were evaluated and assessed. Results: Out of the fifty patients assessed, male patients were mainly affected (86%). The most affected age group was 31–40 years (64%) followed by 41–50 years (22%). Right hypochondrium pain was the most common presenting complaint. Nine patients (18%) had presented with signs of toxemia. Only right lobe of the liver was affected the most in 44 patients (88%). Escherichia coli was the most common organism isolated in our study in 19 patients (38%). A total of 19 patients (38%) had diabetes in our study and total of 13 patients had mortality in our study. Conclusion: Ruptured liver abscess most commonly involves the right lobe of the liver. Males are affected far higher than the females; probable cause believed to be higher alcohol consumption. Most common affected age group falls between 30 and 60 years of age. If prompt treatment is started in time, mortality involved with it is evitable.