A retrospective observational study of liver abscess in children at tertiary care hospital of Ahmedabad city

Unnati S. Asari; Ashish H. Kharadi; Abidali V. Vijapura; Pankti D. Desai; Hitesh R. Dabhi; Tejas A. Chaudhary

doi:10.53730/ijhs.v6nS3.6987

Authors

Unnati S. Asari Assistant professor, Department of pediatrics, AMC MET Medical college, Ahmedabad, India
Ashish H. Kharadi
uasari.ashish@gmail.com
Associate professor, Department of surgery, G.M.E.R.S. Medical College, Vadnagar, India
Abidali V. Vijapura Department of pediatrics AMC MET Medical college, Ahmedabad, India
Pankti D. Desai Associate professor, Department of pediatrics AMC MET Medical College, Ahmedabad, India
Hitesh R. Dabhi 2nd year Resident, Department of pediatrics, AMC MET Medical college, Ahmedabad, India
Tejas A. Chaudhary 2nd year Resident, Department of pediatrics, AMC MET Medical college, Ahmedabad, India

Keywords:

liver abscess, children, percutaneous aspiration, PLA, treatment

Abstract

In developing country like India, liver abscess in children is mostly pyogenic (PLA) in nature. This article aimed to analyze detail parameters of LA of admitted cases in tertiary care hospital of Ahmedabad city. Details of 32 patients From1 month to 14 years age groups were assessed retrospectively over periods of 2 years. The demographic profile, clinical presentation, laboratory and ultra sonographic, microbiological profile, management and outcome of patients were retrieved from case records. All cases had PLA with mean age 6 years and male predominance (64.28%). Under nutrition and enteric fever were only risk factors derived. Fever (93.75%) and abdominal pain (68.75%) were commonest presentation of LA. Leukocytosis found in 62.5% cases with neutrophilic predominance. Majority of LA were single (90.6%), in right lobe of liver (68.8%) with more than 50mm in size. Positivity rate of pus and blood culture in 12.5% and 15.62% cases respectively where staphylococcus aureus is commonest organism.17 cases (53.12%) require antibiotics treatment alone ,14 cases (43.75%) USG guided needler aspiration and 1 case (3%) open surgical drainage with 100%recovery rate. PLA is commonest in children and cryptogenic in origin. Management of LA required multidisciplinary approached include antibiotic and/or USG guided percutaneous needle aspiration.

Downloads

Download data is not yet available.

References

Kirtisudha Mishra, Srikanta Basu, Subhasis Roy Choudhary. Liver abscess in children: an overview. World journal of paediatric 2010; 6(3):210-216.

A, Srinivasan S, Sharma AK. Pyogenic liver abscess in children – South Indian experiences. J 0PediatrSurg 1998 Mar; 33(3):417-421.

Hendricks MK, Moore SW, Millar AJ. Epidemiological aspects of liver abscesses in children in the Western Cape Province of South Africa. J Trop Pediatr 1997 Apr; 43(2):103-105.

Hansen PS, Schonheyder HC.pyogenic hepatic abscess .A 10 years population based retrospective study. APMIES 1998;106:396-402

Kong MS, Lin IN. Pyogenic liver abscess in children. J Formos Med Assoc. (1994) 93:45-50.

Pineiro-Carrero VM, Andres JM. Morbidity and mortality in children with pyogenic liver abscess. AM J Dis child 1989;143:1424-1427

M.P Sharma, Arvind Kumar. Liver abscess in children. Indian J Pediatr 2006; 73(9):813-817.

Haque R, Huston CD, Hughes M, Houpt E ,Petri WA Jr. Amoebiasis. N Engl J Med 2003;348:1565-1573.

Wells CD, Arguedas M. Amoebic liver abscess. South Med J 2004;97:673-682

Yeh P-J, Chen C-C, Lai M-W, Yeh H-Y and Chao H-C(2020) Pediatric Liver Abscess: Trends in the Incidence, Etiology, and Outcome Based on 20 – Years of Experience at a tertiary center. Front. Pediatr. March 2020/volume 8/ Article 111

SM, Salahi H, Bahador A, Abbasy HR, Salahi F. Liver abscess in children: A 10-year single centre experience. Saudi J Gastroenterol 2011:17:199-202.

Waghmare M, Shah H, Tiwari Management of liver abscess in children: Our experience. Euroasian J Hepato -Gastroenterol 2017;7(1):23-26

Ferreira MA, Pereira FE. Musso C. Dettogni RV. Pyogenic liver abscess In children: some observations in the Espirito Santo State, Brazil, Arg Gastroenterol (1997) 34:49-54.

Oguzkurt P. Tanyel FC, Büyükpamukçu N. Hiçsönmez A. Ancreased risk of pyogenic liver abscess in children withPapillon-Lefevre syndrome. J PediatrSurg 1996:31:955-956.

Mishra K, Basu, S, Subhasis Roy Choudhary. Liver abscess in children: an overview. World journal of paediatric 2010;6(3):210-216.

Hsu YL. Lin HC. Yen TY. Hsieh TH. Wei HM. Hwang KP. Pyogenic liver abscess among children in a medical center in Central Taiwan. J Microbiol Immunol Infect. (2015) 18.302-5. doi: 10.1016/).jmil.2013.08.009

Tai FC, Huang YT, Chang LY, Wang JT. Pyogenic liver has endemic disease, Taiwan. Emerg Infect Dis. (2008) 741592-600, doi: 10.3201/eid1410.071254

TaiCC, Chung JH, Ko SF, Liu PM, Su CT, Li WC, et al. Liver abscess in children: a single institutional experience in southern Taiwan, ActaPaediatr. (2003) 44:282-6, doi: 10.7097/APT.200310.0282

Bari S, Sheikh KA, Malik AA, Wani RA, Naqash SH. Percutaneous aspiration versus open drainage of liver abscess in children. PediatrSurgInt 2007 Jan;23(1):69-74.

Donovan AJ, Yellin AE, Rall PW. Hepatic abscess. World J Surg 1991 Mar-Apr;15(2):162- 169.

Sadhna BhasinLal, VubhunaxVenkateshAditikarma.The pediatric infectious disease journal;2021:40(5):179-184)

Jain M. Jain J, Gupta S. Amebic liver abscess in children-experience from Central India. Indian J Gastroenterol.2016;35:248-249.

Salim A, Jeelani SM, Qazi SH, et al. Amoebic liver abscess: outcomes of percutaneous needle aspiration vs drain placement in paediatric population. J Pak Med Assoc. 2019; 69(suppl 1): S29-S32.

Cheema HA, Saeed A. Etiology, presentation and management of liver abscesses at the Children’s Hospital Lahore. Annals 2008; 14:148-150.

Barakate MS, Stephen MS, Waugh RC, Gallagher PJ, Solomon MJ, Storey DW, Sheldon DM. Pyogenic liver abscess: a review of 10 years' experience in management. Aust NZJ Surg 1999 Mar;69(3):205-209.

Kouassi-Dria AS, Moh NE, Aké YL, Midekor-Gonebo K, Keita B, Bonny-Obro R, et al. Liver abscess of children in Côte-d’Ivoire. Ann Pediatr Surg, (2018) 14:51–5, doi: 10.1097/01.xps.0000521800.43379.30

Muorah M, Hinds R. Verma A. Yu D, Samyn M. Mieli-Verganial. Liver abscesses in children: a single center experience in the developed world. J Pediatr Gastroenterol Nutr. (2006) 37, Bhatt GC42:201-6. doi: 10.1097/01.mpg-0000189344.23387.26

Kleinman RE, Goulet O, Mieli-Vergani G, Sanderson IR, Sherman PM, Shneider BL. Walker’s Pediatric Gastrointestinal Disease: Pathophysiology. Diagnosis, Management. Raleigh, NC: People’s Medical Publishing House (2018).

Kumar A, Kapoor R, Chopra K, Sethi GR, Saha MM. Typhoid fever. Unusual hepatic manifestation. Clin Peadiatr (Phila) 1989 Feb;28(2):99-100