Management Issues in Paediatric Liver Abscesses

Background: With evidence of increasing incidence, Liver abscesses remain an important cause of morbidity in children. Evaluation of the clinical profile and management outcomes of pediatric liver abscess would guide evidence-based management.

Objectives: To determine how physical characteristics of Paediatric liver abscesses guide intervention and eventual treatment outcome.

Methods: A retrospective, observational, cohort study was conducted on all LA patients managed from February 2011 to August 2016. Data regarding symptoms, possible predisposing factors, method of diagnosis, any interventions, and duration of stay were collected and analyzed. Sonographic characteristics of the lesion guided management in the study.

Results: Thirty two patients with a mean age of 5.52 years were managed during this period. The clinical features were fever (25, 78%), pain in right hypochondrium (19, 59%), abdominal distension (4, 12.5%), subacute intestinal obstruction (2, 6.25%), and peritonitis (2, 6.25%). Three patients experienced abscess rupture. In three patients, conservative treatment was successful. In five individuals with a size of less than 100ml, USG guided needle aspiration was effective. In 21 patients with bigger lesions, pigtail insertion was required. In three individuals, a laparotomy was performed. One patient died as a result of severe sepsis and coagulopathy. All of the other patients were released.

Conclusions: LA is an important cause for morbidity in children. It could lead to rupture and death if it isn't treated. High suspicion, early screening, and proper intervention in form-tailored management may yield positive outcomes.