Muhammad Khalid, Farhat Mirza, Jamshed Akhtar, Abdul Aziz.
Results of different modes of management of Liver Abscess in Children.
J Surg Pak Jan ;8(2):20-2.

Liver abscess is not an uncommon problem in children. Different modes of management are described in literature, but the best one is still controversial The purpose of this study was to compare the results of different modes of management of liver abscesses in children, so as to suggest the most appropriate method of dealing with this condition in sense of early recovery, at minimum cost and with least complications. This study was carried out on 38 children with liver abscess during one year period, from 1st January 1999 to 31st December 1999 at the National Institute of Child Health, Karachi. Diagnosis was made on history, examination and investigations. Ultrasound and IHA(indirect hemagglutination antibodies) were the main diagnostic tools. Abscesses larger than 5cm.were managed by drainage. Three subgroups were formed. These were; Percutaneous needle aspiration, percutaneous tube drainage and drainage by laparotomy. Results were analysed in terms of complications, cost and duration of illness. All different modes of management remained successful. There was no mortality. Recurrence was noted in one patient in percutaneous needle aspiration, which was managed by second aspiration. Granulation tissue formation was found at site of exit of tube after percutaneous tube drainage in two cases. In open drainage two patients developed excessive bleeding, in three patients contamination of peritoneal cavity occurred during procedure and in one patient fits and septicaemia developed. It is thus concluded that abscesses more than 5cm (uncomplicated) can successfully be drained by percutaneous needle aspiration under ultrasound guidance. The method was found safe, cost effective and with least complications.

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