Pyogenic liver abscess--a neglected diagnosis

Australian and New Zealand Journal of Medicine
N L SandfordL W Powell

Abstract

Twenty-five patients with pyogenic liver abscess admitted to the Royal Brisbane Hospital between 1970 and 1982 have been reviewed. The mortality rate was 32%; however, all patients who were diagnosed before death survived. In seven patients there was a history of biliary obstruction or biliary surgery of whom six died. The mean age of the patients who died was significantly higher than those surviving and it is suggested that this resulted from overdiagnosis of malignancy in the elderly, some hesitancy in investigating older patients, and a tendency to attribute multiple space-filling defects to metastatic tumour. If liver biopsy or even exploratory laparotomy have failed to confirm the diagnosis of hepatic abscess the clinician should not discard the possibility. It is concluded that the continuing high mortality from liver abscess is in large part due to lack of clinical awareness and failure in diagnosis rather than to inadequate therapy.

References

Sep 20, 1980·Lancet·M R PereraP Noone
Jan 16, 1982·Lancet·D A HerbertJ Ruskin
Jan 1, 1982·The British Journal of Surgery·J M NorthoverR Williams
Jul 1, 1980·World Journal of Surgery·A P McDonald, R J Howard
Sep 17, 1981·The New England Journal of Medicine·S G GerzofD C Nabseth

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Citations

Apr 1, 1986·The Australian and New Zealand Journal of Surgery·M D LevittH J Sheiner

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