Liver abscess of children in Côte-d’Ivoire: retrospective analysis of a series of 30 cases

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Abstract

Objective

The aim of this study was to report the results of liver abscess management in children.

Patients and methods

We conducted a retrospective and descriptive study of 30 cases of liver abscesses collected over 9 years (March 2007 to February 2016). The following variables were studied and results were judged on the clinical and ultrasound follow-up: age, sex, hepatodigestive past history, evolution delay, clinical presentation, size, site, and number of collected pouch, HIV serology, bacteriologic exams, and management modalities.

Results

Our series was made up of 18 boys and 12 girls with a mean age of 5.4 years. A past history of bloody saddles was noted in five cases. Fontan’s triad combining a painful hepatomegaly with fever was observed in 25 patients. The collection was multiple in seven cases. The right lobe was found to be the most affected in 20 (66.7%) cases. The mean diameter was 11.8 cm with extremes ranging from 4 to 18 cm. The amoebic serology was positive in nine (30%) cases and Staphylococcus aureus was found in four cases. Four patients were subjected to an exclusive medical treatment. An ultrasound-guided evacuating puncture and drainage were carried out, respectively, in five and 17 patients. A laparotomy was carried out in four patients, of which two were after secondary abscess rupture. Mortality was nil. No recurrence was recorded with a mean follow-up of 4.5 years.

Conclusion

Liver abscess is not exceptional in the Ivory Coast paediatric hospital environment and constitutes a medicosurgical emergency with a good prognosis whose well-coded management needs to be early.

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