Diagnosis and treatment of pyogenic liver abscess in elderly patients by multislice CT / 临床肝胆病杂志

ABSTRACT

Objective To review the multislice computed tomography (MSCT)characteristics and treatment of pyogenic liver abscess in elderly patients.Methods A retrospective analysis was performed on the clinical data of 42 elderly patients who were diagnosed with pyo-genic liver abscess in our hospital from March 2001 to February 2014.The MSCT characteristics and clinical treatment of this disease were reviewed.Comparison between two groups was made by t test.Results Among the 42 patients,37 had the liver abscess in the right lobe, and 5 in the left lobe;33 had single lesions,and 9 had grid-or honeycomb-like lesions.MSCT scan showed that all lesions had a lower density compared with normal hepatic tissues,and the CT values were approximately 6 -40 Hu.In the arterial phase,39 patients had le-sions with peripheral rim enhancement,and 3 had no edge enhancement.Conservative treatment was given to 15 patients,among whom the diameter of abscess was 3.7 ±2.1 cm,the duration of fever was 11.7 ±4.1 d,and the average hospital stay was 22.6 ±5.3 d.Percutane-ous drainage was performed in 27 patients,among whom the diameter of abscess was 6.3 ±2.8 cm,the duration of fever was 7.1 ±2.2 d, and the average hospital stay was 13.7 ±3.1 d.There were significant differences in the diameter of abscess,the duration of fever,and the length of hospital stay between the two groups (P=0.021,0.026,and 0.006,respectively).Conclusion MSCT can accurately reveal the location and morphology of abscess,and correct diagnosis can be made in combination with the patient's medical history.Drainage guided by ultrasound or CT is an effective,minimally invasive,and safe treatment for controlling fever and promoting fast recovery in the elderly.