AN INITIAL EXPERIENCE OF ULTRASOUND GUIDED PIGTAIL CATHETER DRAINAGE OF LIVER ABSCESS AND ITS OUTCOME IN TERTIARY CARE HOSPITAL OF QUETTA.

Abstract

Background: Liver abscess is a common clinical problem in tropical countries and is most commonly caused by pyogenic, amoebic or mixed infections. Abscess is usually suspected clinically in cases having fever, tender hepatomegaly and the diagnosis is usually confirmed on the basis of imaging such as ultrasound and computerized tomography. Management includes antimicrobial agents and drainage of abscess. Percutaneous drainage (PD) of abscess is done using needle aspiration or by pigtail catheter drainage.

Aims and Objective: To evaluate the role of ultrasound guided pigtail catheterization drainage procedure as a treatment option in cases of liver abscess.

Materials and Methods: It was a prospective study conducted at the Radiology department of Bolan Medical Complex Hospital, Quetta, Pakistan from August 2021 to September 2022.  Forty eight patients diagnosed as hepatic abscess were included in this study on the basis of predefined inclusion and exclusion criteria. These patients underwent pigtail catheterization of liver abscess as a part of their treatment. The patients included in the study were diagnosed with liver abscess by ultrasound and CT and were treated in coordination with surgery department. The effectiveness of pigtail drainage was evaluated by doing serial ultrasound scans.The demographic characteristics, hepatic lobe involvement, amount of pus drained and complications were studied in these patients.

Results: Out of 48 patients, 32 were male and 16 were female with a M: F ratio of 2:1.The age ranged from 10 years to 70 years. The mean age of the study cases was found to be 35-40 years. Right lobe was involved in predominant cases. Eight patients developed procedure related complications out of which 3 had catheter blockage,2 patients had catheter dislodgment requiring repositioning, 2 patient developed pus discharge from catheter site and remaining 1 patient developed subcapsular hematoma. Average hospital stay varied from 2–5 days. No major complications reported during the procedure.

Conclusion: Percutaneous ultrasound guided pigtail catheter is an effective minor invasive procedure as a treatment option for liver abscess with high success rate and no procedure related mortality.

Keywords: liver abscess, Pig tail catheter, percutaneous drainage