Title: Ultrasound Guided F.N.A.C. is the Excellent Methods for the Diagnosis of Pyogenic Liver Abscess (PLA) in patients Attending in Tertiary Care Hospital, at N.M.C.H. Patna
Authors: Dr Manohar Lal, Dr O. P. Dwivedy
DOI: https://dx.doi.org/10.18535/jmscr/v7i6.60
Abstract
Objective: The aim of present study was to evaluate the role of Ultrasound guided F.N.A.C in the diagnosis of Pyogenic liver abscess (PLA) and know the etiopathogenesis, clinical characteristics, Radiological finding and management of pyogenic liver abscess.
Materials and Methods: A total of 36 patients of different age groups of both sexes presenting with complain of right hypochondrial pain and fever were attending in surgical and medical OPD were referred for Ultrasound guided FNAC in our department were included in the study. After thorough clinical history, all the patients were subjected to proper clinical examination. Prior to FNAC all the relevant routine investigation like CBC, ESR, LFT, KFT, BT, CT. Blood Sugar, Viral Markers were performed and written consent were taken. After preparation of patient FNAC was done by 10 ml syringe with 22 gauze needle in the presence of radiologist by Ultrasound Machine, Aspirated Materials were placed on grease free slide and fix. From aspirated samples grams staining and culture and sensitivity was done. The entire fixed smear were stained by Giemsa and papanicolaou stain and examined under oil immersion microscope.
Results: Out of 36 patients of PLA, 27 (75%) are male and 9 (25%) were female, with male to female ratio 3:1, patients age group was ranging from 12-63 yrs, with mean age was 36 year. Majority of patients 34 (94.5%) present with upper abdominal pain followed by fever with rigor in 23(63.8%). After clinical examination tenderness was seen in right hypochondrium in 33 (91.6%) patients. Majority of liver abscess was seen in Right lobe of liver in 29 (80.5%) patients, Most common organism isolated was klebsiella spp. in 16 (44.44%) cases and E.coli in 12 (33.33%) cases. Patients were responding well to Cephalosporins, Metronidazole, Fluroquinolones and Aminoglycosides. USG Guided FNAC was effective in 78% of cases.
Conclusion: Early diagnosis and prompt treatment of pyogenic liver abscess save the life of patient, because if not treated, may be fatal.
Keywords: pyogenic Liver abscess, bacteria, culture.
References
- Krije JE Beckin6ham IJ:ABCD diseases of liver, pancreas and biliary system. BMJ 2001, *322(7285):537-540
- Seeto RK, Rockey DC(1996)Pyogenic liver abscess, changing, etiology, management and outcome. Medicine (Baltimore)75:99-113
- Bourne WA (1954) The diagnosis of pyogenic liver abscess. Lancet 2:1093-1094
- Stain SC, Yellin AK, Donovan AJ et al (1991)Pyogenic liver abscess : modern treatment. Arch Surg 126:991-996
- Lee KT, Wong SR, Sheen SR (2001)Pyogenic Liver abscess. Dig Surg 18:459-465
- Ochsner A, DeBaker M, Murray, S(1938)Pyogenic abscess of Liver2. An analysis of 47 cases with review of literature. Am J Surg 40:292-319.
- Miedema BW, Dineen P (1984) The Dignosis & Treatment of Pyogenic Liver Abscess- Ann Surg 200(3): 328-334.
- Ehud M (1984) rare complication after Tran-abdominal five needle aspiration. Am Jenner Gastrocenterlogy 6.85-60
- Eriksson (1984) Effect of F.N.A.C. on Flemon dessiminetion it mice cancer 54-73-78.
- Ferucci Jr-P Wittenberg J. (1981) Diagnosis of spelomihal malignancy by rediologically fine – needle aspirtion biosphy. Am Tr. Radiol – 134 – 323-330.
- Thomson-P Thin needle aspiration biopsy Acta. Cytol- 26.262-263 (1982).