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.
