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[Pyogenic liver abscesses: a study of 25 cases].

OBJECTIVE
Our aim was to study the anatomo-clinic particularities and the therapeutic modes of the infectious abscesses of the liver.


PATIENTS AND METHODS
Our retrospective study concerns 25 cases of the infectious abscesses of the liver collected on one period of 12 years from January 1992 to December 2003. They are 11 primitive abscesses and 14 secondary abscesses.


RESULTS
We noted 14 women and 11 men, median age was 51.5 years. The Fontan triad was present in 7 cases. A liver mass with an abdominal sensitivity was found in 14 cases. Anomalies in the biologic exam of the liver were present in the 1/3 of the cases. We noted a double right and left localization in 3 cases and a multiple localization in 1 case. The hemoculture and the pyoculture permitted a bacteriological diagnosis in 52%. The percutaneous treatment achieved in 7 cases, permitted the recovery in 2 cases. One dead was noted following a severe cardiopathy. A surgical drainage has been achieved at 22 patients. 4 cases after the failure of the percutaneous treatment. Mortality rate was 20% (5 cases) related to the delay of diagnosis, the gravity of the septic shock. the advanced age and the flaws associated.


CONCLUSION
The infectious abscess of the liver was a serious affection that affects the vital prognosis. The percutaneous treatment associated to the antibiotherapy. is the method of choice in the treatment of the abscesses of the liver. The surgical treatment must be reserved to the failure of the percutaneous treatment.