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Role of USG Guided Percutaneous Needle Aspiration in Pyogenic Liver Abscess

Arun Dhankhar, Ravi Mathur


Background: Liver abscess has been a condition of high mortality and morbidity in past but since there is work done over decades with use of percutaneous aspiration and percutaneous drainage along with antibiotics; percutaneous drainage is currently the treatment of choice in liver abscess. Percutaneous needle aspiration (PNA) as an alternative to continuous percutaneous catheter drainage in combination with systemic antibiotics for the treatment of PLA has never been popular.
Aims and Objectives: To analyze the role of ultrasound (USG) guided percutaneous needle aspiration in the treatment of PLA.
Material and Methods: A total number of 25 patients over a time period from March 2016 to February 2017 irrespective of their age. All patients with PLAs underwent PNA with ultrasound (USG) guidance and antibiotic therapy. Complete pus removal from each abscess was attempted with 18 gauge thin-walled trocar needles with USG guidance.
Results: The rate of success was unrelated to the large size or number of abscess in the patient. A complete cure (normalization of clinical and laboratory parameters and resolution of hepatic lesions) was achieved in all the patients (100%). Imaging-guided percutaneous catheter drainage or open surgery was not needed in any of the patient. Neither complications nor deaths ensued. Recurrence rate was nil.
Conclusions: PNA with USG-guided in treatment for PLA is a low-cost, safe and effective procedure. It should be considered as a first line alternative to catheter drainage. Our data suggest that a trial of percutaneous needle aspiration should always be undertaken before catheter drainage or surgery.

Keywords: Pyogenic liver abscess, ultrasonography, percutaneous needle aspiration

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Arun Dhankhar, Ravi Mathur. Role of USG Guided Percutaneous Needle Aspiration in Pyogenic Liver Abscess. Research & Reviews: Journal of Surgery.

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