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Article: Pyogenic liver abscess: An audit of experience over the past decade

TitlePyogenic liver abscess: An audit of experience over the past decade
Authors
Issue Date1996
PublisherAmerican Medical Association. The Journal's web site is located at http://www.archsurg.com
Citation
Archives Of Surgery, 1996, v. 131 n. 2, p. 148-152 How to Cite?
AbstractObjectives: To audit our experience in managing patients with pyogenic liver abscesses since 1984 and to identify any risk factor associated with hospital mortality. Design: Retrospective review. Setting: A tertiary referral center. Patients: Eighty-three patients with pyogenic liver abscesses were studied to determine demographic characteristics; clinical features, laboratory, imaging, and microbiologic findings; methods of treatment; and final outcome. The median follow-up period was 9.8 months. Intervention: All patients were treated with intravenous antibiotic drugs. Fifty-three patients were subjected to image-guided percutaneous aspiration of the abscess. A percutaneous drainage catheter was inserted after aspiration in 27 patients. Laparotomy was performed in 27 patients; seven of them underwent an elective operation. Main Outcome Measures: Hospital mortality, defined as death within the same hospital admission for management of liver abscess. Results: Biliary tract disease was the most frequently identifiable cause. The right lobe abscess was more frequently cryptogenic, while the left lobe abscess was more frequently related to intrahepatic stones (P<.001). The overall hospital mortality rate was 18% (15/83). On univariate analysis, female gender, rupture on presentation, emergency laparotomy, management without aspiration or catheter drainage, presence of malignancy, hyperglycemia, hyperbilirubinemia, elevated prothrombin time, and elevated activated partial thromboplastin time were significantly associated with hospital mortality. On multivariate logistic regression analysis, presence of malignancy, hyperbilirubinemia, and elevated activated partial thromboplastin time were found to be independent risk factors. Conclusions: Pyogenic liver abscess is still a disease with significant mortality. Early diagnosis and prompt treatment are necessary to further improve our results of management.
Persistent Identifierhttp://hdl.handle.net/10722/83667
ISSN
2014 Impact Factor: 4.926
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorChu, KMen_HK
dc.contributor.authorFan, STen_HK
dc.contributor.authorLai, ECSen_HK
dc.contributor.authorLo, CMen_HK
dc.contributor.authorWong, Jen_HK
dc.date.accessioned2010-09-06T08:43:45Z-
dc.date.available2010-09-06T08:43:45Z-
dc.date.issued1996en_HK
dc.identifier.citationArchives Of Surgery, 1996, v. 131 n. 2, p. 148-152en_HK
dc.identifier.issn0004-0010en_HK
dc.identifier.urihttp://hdl.handle.net/10722/83667-
dc.description.abstractObjectives: To audit our experience in managing patients with pyogenic liver abscesses since 1984 and to identify any risk factor associated with hospital mortality. Design: Retrospective review. Setting: A tertiary referral center. Patients: Eighty-three patients with pyogenic liver abscesses were studied to determine demographic characteristics; clinical features, laboratory, imaging, and microbiologic findings; methods of treatment; and final outcome. The median follow-up period was 9.8 months. Intervention: All patients were treated with intravenous antibiotic drugs. Fifty-three patients were subjected to image-guided percutaneous aspiration of the abscess. A percutaneous drainage catheter was inserted after aspiration in 27 patients. Laparotomy was performed in 27 patients; seven of them underwent an elective operation. Main Outcome Measures: Hospital mortality, defined as death within the same hospital admission for management of liver abscess. Results: Biliary tract disease was the most frequently identifiable cause. The right lobe abscess was more frequently cryptogenic, while the left lobe abscess was more frequently related to intrahepatic stones (P<.001). The overall hospital mortality rate was 18% (15/83). On univariate analysis, female gender, rupture on presentation, emergency laparotomy, management without aspiration or catheter drainage, presence of malignancy, hyperglycemia, hyperbilirubinemia, elevated prothrombin time, and elevated activated partial thromboplastin time were significantly associated with hospital mortality. On multivariate logistic regression analysis, presence of malignancy, hyperbilirubinemia, and elevated activated partial thromboplastin time were found to be independent risk factors. Conclusions: Pyogenic liver abscess is still a disease with significant mortality. Early diagnosis and prompt treatment are necessary to further improve our results of management.en_HK
dc.languageengen_HK
dc.publisherAmerican Medical Association. The Journal's web site is located at http://www.archsurg.comen_HK
dc.relation.ispartofArchives of Surgeryen_HK
dc.titlePyogenic liver abscess: An audit of experience over the past decadeen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0004-0010&volume=131&spage=148&epage=152&date=1996&atitle=Pyogenic+liver+abscess:+an+audit+of+experience+over+the+past+decadeen_HK
dc.identifier.emailChu, KM: chukm@hkucc.hku.hken_HK
dc.identifier.emailFan, ST: stfan@hku.hken_HK
dc.identifier.emailWong, J: jwong@hkucc.hku.hken_HK
dc.identifier.authorityChu, KM=rp00435en_HK
dc.identifier.authorityFan, ST=rp00355en_HK
dc.identifier.authorityWong, J=rp00322en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1001/archsurg.1996.01430140038009-
dc.identifier.pmid8611070-
dc.identifier.scopuseid_2-s2.0-0030020316en_HK
dc.identifier.hkuros22176en_HK
dc.identifier.hkuros10986-
dc.identifier.volume131en_HK
dc.identifier.issue2en_HK
dc.identifier.spage148en_HK
dc.identifier.epage152en_HK
dc.identifier.isiWOS:A1996TV00200008-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridChu, KM=7402453538en_HK
dc.identifier.scopusauthoridFan, ST=7402678224en_HK
dc.identifier.scopusauthoridLai, ECS=36932159600en_HK
dc.identifier.scopusauthoridLo, CM=16319169300en_HK
dc.identifier.scopusauthoridWong, J=8049324500en_HK

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