B0592 - Role of Hepatectomy in Patients With Liver Abscess: A Single Center Experience

Monday, October 24, 2022

10:00 AM – 12:00 PM ET

Location: Crown Ballroom

Has Audio

Presenting Author(s)

Antoine Boustany, MD, MPH

Cleveland Clinic Foundation
Cleveland, OH

Antoine Boustany, MD, MPH¹, Aiman Obed, MD, PhD², Mohammad AbuAssi, MD², Abdalla Bashir, MD², Anwar Jarrad, MBBS²
¹Cleveland Clinic Foundation, Cleveland, OH; ²Jordan Hospital, Amman, 'Amman, Jordan

Introduction: Liver abscess is relatively rare and could be lethal if left untreated. Current advances in the management include diagnostic and interventional radiology that have decreased the rate of mortality. The aim of this study is to present four cases of patients with liver abscess who were cured by hepatectomy after failing CT-guided and surgical drainage.

Case Description/Methods: Four cases of patients with liver abscess due to post-radiofrequency ablation in HCC-patient (case 1), unknown etiology (cases 2 and 3), and foreign body injury from a shrapnel (case 4); were selected (Table 1). All of them were treated initially with empiric antibiotics and underwent CT-guided and surgical drainage. They subsequently underwent liver resection as their clinical condition failed to improve. On follow-up, the patients improved and repeat abdominal ultrasonography was negative for recurrence of abscess.

Discussion: Although rare, liver abscess has a high mortality rate. Hence, there is an urgent need to treat this condition upon diagnosis. Recently, percutaneous drainage in addition to empiric antibiotics have been the initial approach for treating the liver abscesses. However, surgical drainage or liver resection can sometimes be considered to treat hepatic abscess in selected cases where the abscess is not accessible to CT-guided percutaneous drainage, if it is ruptured, or if the patient failed to improve with optimized medical therapy and percutaneous drainage. These cases highlight the importance of considering liver resection in curing patients with liver abscess who did not improve with medical therapy and CT or surgical drainage.

Case IV	Case III	Case II	Case I
24	44	48	75	Age
Male	Male	Female	Male	Gender
Foreign body injury from a shrapnel	Cryptogenic	Cryptogenic	Post-radiofrequency ablation in HCC-patient	Cause of liver abscess
Negative	Negative	Negative	Positive	Chronic Hep
250 mg/l	2 mg/l	240 mg/l	249 mg/l	Preop CRP
Pseudomonas aeruginosa and Candida	No growth	No growth	E. Coli (ESBL) and Enterococcus Faecium	Culture

Table: Table 1: Characteristics and laboratory findings of the four patients with liver abscess selected.

Disclosures:

Antoine Boustany indicated no relevant financial relationships.

Aiman Obed indicated no relevant financial relationships.

Mohammad AbuAssi indicated no relevant financial relationships.

Abdalla Bashir indicated no relevant financial relationships.

Anwar Jarrad indicated no relevant financial relationships.

Antoine Boustany, MD, MPH¹, Aiman Obed, MD, PhD², Mohammad AbuAssi, MD², Abdalla Bashir, MD², Anwar Jarrad, MBBS². B0592 - Role of Hepatectomy in Patients With Liver Abscess: A Single Center Experience, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.