The diagnosis and management of patients with pyogenic liver abscesses (PLA) in the last decades has improved with the development of ultrasound (US), computed tomography (CT) and guided percutaneous aspiration and/or catheter drainage interventional procedures, wich carne to substitute or complementate the surgical approach. In a retrospective study of 27 cases in a 15 year period, our main objective was to evaluate the diagnostic an therapeutic resources for the treatment of PIA used in our hospital, and to compare our data to literature. Abdominal pain (96%), fever (92%) and hepatomegaly (85%) were the signs and symptoms most frequently found; bastonetosis (88%), leukocytosis (85%), hypoalbuminemia (77%) and high serum alkhaline phosphatase level (66%) were the most common laboratorial findings. Escherichia coli and Staphylococcus sp were the pathogenous agents most frequently identified. Percutaneous catheter drainage US guided was performed in five patients (19%) and surgical drainage in /6 (59%). The other six patients (22%) were treated only by antibiotics. Three patients died (mortality of /1%). The guided percutaneous aspiration methods present less procedure-related morbidity than surgical drainage, diminishig the contamination risk of the peritoneal cavity avoiding peritonitis, and giving an equally good outcome. Also, the aspiration citology can play an essential complementary role to diagnosis, principally for underlying diseases. Video-laparoscopic drainage is an other method to consider as possible, offering another way before submitting the patient to laparotomy if the possibility of percutaneous guided drainage is gone. So, surgical drainage should be indicated only for patiens with failure of percutaneous drainage or not reachable multiple abscesses, and/or rupture of the PLA. For each case, it must be offered to the patient the best treatment according to the hospital available resources, allowing reduction of mortality and morbity rates.
Liver abscess; Interventional radiology; Surgery; Laparoscopy