PYOGENIC LIVER ABSCESS: DIAGNOSTIC AND THERAPEUTIC MANAGEMENT

ABSTRACT Background: The pyogenic liver abscess has an incidence of 1.1/1,000 habitants. Mortality can reach 100%. The use of less invasive procedures diminish morbidity and hospital stay. Aim: Identify risk factors in patients who underwent percutaneous drainage guided by ultrasound as treatment. Method: Were analyzed 10 patients submitted to the method. Epidemiological characteristics, laboratory markers and imaging exams (ultrasound and CT) were evaluated. Results: The majority of the patients were men with mean age of 50 years old. Liver disease, alcoholism and biliary tract disease were the most common prodromes. Abdominal pain (90%), fever (70%) and jaundice (40%) were the most common clinical manifestations. Mortality of 20% was observed in this series. Hypoalbuminemia and days of hospitalization had a statistically significant positive association with death. Conclusion: The pyogenic liver abscess has subacute evolution which makes the diagnosis difficult. Image exams have high sensitivity in diagnosis, particularly computed tomography. Percutaneous drainage associated with antibiotic therapy is safe and effective therapeutic resource.摘要 背景：化脓性肝脓肿（pyogenic liver abscess）的发病率为每1000名居民1.1例，病死率最高可达100%。采用微创诊疗操作可降低并发症发生率并缩短住院时长。研究目的：明确以超声引导经皮引流作为治疗方案的患者的相关危险因素。方法：纳入接受该治疗方式的10例患者进行回顾性分析，对其流行病学特征、实验室指标及影像学检查（超声与计算机断层扫描（CT））结果进行评估。结果：本队列患者以男性居多，平均年龄为50岁。肝病、酗酒及胆道疾病为最常见的前驱病症。腹痛（90%）、发热（70%）与黄疸（40%）为最常见的临床表现。本研究组病死率为20%。低白蛋白血症与住院时长与死亡结局存在统计学意义上的显著正相关。结论：化脓性肝脓肿呈亚急性病程，这一特征增加了临床诊断难度。影像学检查对该病具有较高的诊断灵敏度，尤以计算机断层扫描（CT）为优。联合抗生素治疗的经皮引流术是安全且有效的治疗手段。