Characteristics and Management of Pyogenic Liver Abscess: A Rural Senegalese Experience

Abstract

Background: The incidence of pyogenic liver abscess (PLA) has increased in recent years with the development of digestive surgery, particularly hepatobiliary surgery. In recent decades, progress in diagnostic techniques have improved patient prognosis. In Senegal, there are few studies of PLA. This study was carried out within this context. Objective: The main objective was to describe the profile and the management of pyogenic liver abscesses cases in rural Senegal. Results: We collected 17 cases of PLA among 47.553 patients, during the study period, representing a hospital frequency of 0.035%. The mean age of patients was 48.6 ±  18.9. The sex ratio (M/F) was 2:4. Most of the patients (58.82%) had at least one risk factor, the main ones being smoking, a history of abdominal surgery and alcoholism. Right upper abdominal pain was the main reason for consultation (94.11%). Right basithoracic pain and cough were the most frequent respiratory symptoms. Escherichia coli remained the most frequently isolated bacteria. The mean time to diagnosis was 17.8 days ± 14.4. All patients received antibiotic therapy, which was combined with echo-guided liver aspiration in 58.82% cases. Mean hospital stay was 17.5 days ± 7.65. The hospital lethality rate was 29.41%. Conclusion: Liver abscesses are most often of amoebic origin in our context, but in recent years there has been an increase in cases of pyogenic liver abscesses, with the progress made in diagnosis.