Etiology, Presentation and Management of Liver Abscesses at the Children’s Hospital Lahore

Abstract

Background:  Liver abscess is a common problem among children. The purpose of this study is to describe the etiology, different management strategies and outcome of children with liver abscess in Children’s Hospital Lahore.

Patients and Methods:  This study included 38 children with liver abscess seen during two-year period, from September 2004 to September 2006 at the Children’s Hospital and Institute of Child Health, Lahore. Diagnosis was made on history, examination and investigations. Ultrasound and CT scan were the main diagnostic tools.

Results:  Out of 38 patients, 33 children underwent aspiration and remaining 5 were managed conservatively.  Eight aspirates yielded positive culture for various organisms. Three patients were positive for E.Coli, 2 for Staph Aureus, and 1 each case of Klebsiella and Pseudomonas. One patient had multiple micro-abscesses and was also positive for typhidot IgM. Another patient was positive for acid fast mycobacterium tuberculosis. All patients recovered from their abscesses. There was no mortality reported.

Conclusions:  In our pediatric population, liver abscess are mostly caused by pyogenic organisms. Amebic etiology was not proven in any case. Majority of liver abscesses can be satisfactorily treated by aspiration and /or percutaneous image guided drainage with satisfactory outcome.

Key Words:  Liver abscess, children.