A Study on the Etiologies and Predisposing Conditions of Liver Abscess for Recent 10 Years in Chonnam Province

Seo, Kang Suk; Joo, Young Eun; Kim, Hyun Soo; Rew, Jong Sun; Kim, Sei Jong

Abstract

Liver absess is still one of the clinically significant diseases because of its incidence and mortality. Many clinical studies of liver abscess in Korea have been described. But detailed long-term study for the etiologies and predisposing conditions of liver abscess is limited. For study of changing pattern of etiologies and predisposing conditions, a clinical study was performed in 104 patients treated for pyogenic and amebic liver abscess at Chonnam University Hospital for recent 10 years from January, 1989 to December, 1998. The data of early five years and those of late five years were compared statistically. Most liver abscess was pyogenic with no significant interval change in incidence (94.7% in early five years and 97.0% in late five years, respectively; 96.2% in total). 3 cases (3.0% of pyogenic liver abscess) of gas-forming liver abscess were observed. Amebic liver abscess was found in 4 cases (3.8%). Culture was positive in 44.4% and 35.9%, respectively (39.0% in total) in pyogenic liver abscess. Monomicrobial infection was more common than polymicrobial infection (84.6% vs 15.4%) in pyogenic liver abscess. Isolated organisms were most commonly Gram negative aerobes (64.5%), followed by Gram positive aerobes, Gram negative anaerobes and Gram positive anaerobes. Klebsiella was the most frequently isolated organism (25.6%). The common associated diseases or conditions were intrahepatic bile duct stones (22.0%), common bile duct stones (15.0%), history of cholecystectomy (14.0%), gallbladder stones (9.0%), clonorchiasis (8.0%) and diabetes mellitus (10.0%). The most important portal of entry in pyogenic abscess was biliary tract (49.0%), followed by cryptogenic (43.0%), hematogenous (4.0%), traumatic (3.0%) origin and direct extension. There was no statistically significant interval changes in etiologies and predisposing conditions of liver abscess in Chonnam Province.