Clinical characteristics of cryptogenic pyogenic liver abscess

doi:10.19538/j.cjps.issn1005-2208.2017.02.16

Abstract：Objective To explore the clinical characteristics of cryptogenic pyogenic liver abscess (PLAC) and provide evidence for clinical decisions. Methods The clinical data of 86 patients with PLA admitted in Department of Hepatobiliary and Pancreatic Surgery, the Second Affiliated Hospital of Zhejiang University School of Medicine from January 2013 to June 2016 were analyzed retrospectively. According to etiology, the patients were classified as cryptogenic group (n=51) and non-cryptogenic group (n=35). Clinical manifestation, laboratory and pathogenic examination, treatment and prognosis were compared. Results Compared with non-cryptogenic group, the mean age and rate of biliary calculi and malignance were lower in cryptogenic group, while the rate of male and diabetes mellitus were higher (P<0.05). The rates of decreased PLT and elevated TBil in cryptogenic group were lower than those of non-cryptogenic group (P<0.05). Although klebsiella pneumoniae was the main pathogen in both groups, its rate in cryptogenic group was higher than that in non-cryptogenic group, while the rate of E. coli was lower in cryptogenic group (P<0.05). The cryptogenic group had better prognosis, which presented shorter hospital stay and less adverse events (P<0.05). Conclusion PLAC tends to appear mostly in middle-aged and old men with diabetes mellitus. Klebsiella pneumoniae is the major pathogen. Controlling serum glucose, anti-infection and percutaneous drainage are effective treatment methods to gain better prognosis.