Frequency of clinical manifestations, in cases of liver abscess in hospital based study

The study was designed to determine frequency of clinical manifestations, associated risk factors and early diagnosis to avoid complications in cases of liver abscess in hospital based study. Descriptive study. This study was conducted in the Medical Unit, Bolan Medical Complex Hospital, Quetta, Pakistan from August 2006 to Feb: 2008. 100 consecutive cases of liver abscess were reviewed. 99 cases [99%] were amoebic and 01 [1%] gynogenic. Majority of liver abscess were single and in right lobe [92%]. Four [04%] in left lobe and four [04%] in both lobes. Ultrasound guided aspiration with metronidizole was performed in 35% of our patients. These patients had abscess that were usually larger then 5cm in diameter. The other cases were managed initially empirically with parental antibiotics then with oral antibiotics. We found that percutaneous aspiration of liver abscess is helpful to confirm diagnosis provides the a better bacteriological culture yield, gives a good outcome and may uncover clinically unsuspected conditions like malignancy and tuberculomas which may mimic the presentation of liver abscess. We recommend that ultrasound guided aspiration is a safe, economical easy way of management of liver abscess with low morbidity and negligible mortality

Profile of extrahepatic portal venous obstruction [EHPVO] in a tertiary care hospital in Pakistan

To study the clinical and laboratory profile of patients with EHPVO in a tertiary care hospital of Pakistan and to differentiate EHPVO from cirrhosis of liver and to see the effect on liver function tests. This is a prospective observational study conducted at Department of Gastroenterology, Pakistan Institute of Medical Sciences, Islamabad.Twenty five patients of 12-55 years of age with the features of portal hypertension were included in this study. After careful history and physical examination patients were subjected for laboratory investigations including liver function test, renal function test, blood CP, PT, APTT, HbsAg and anti HCV, other specialized procedures including endoscopy, liver biopsy and ultra sound was also done in all patients. Portal vein thrombosis was the predominant cause of EHPVO, accounting for 88% of cases. All patients were presented with upper GI bleeding, splenomegaly was observed in 88% of patients. None of the patients had clinical, biochemical or liver biopsy evidence of chronic liver disease. The diagnosis of extra hepatic portal venous obstruction and differentiation from cirrhosis can be easily made by characteristic clinical features, normal liver function tests and doppler ultrasound. Portal vein thrombosis [PVT] is the predominant cause of EHPVO in Pakistani patients, as seen at this tertiary care hospital in Pakistan