Đặc điểm lâm sàng, cận lâm sàng ở bệnh nhân áp xe gan điều trị tại Bệnh viện Trung ương Quân đội 108

Abstract

Objective: To present a clinical, paraclinical, and microbiological profile of patients with liver abscesses receiving treatment at 108 Military Central Hospital. Subject and method: This retrospective cross-sectional investigation examined 196 patients diagnosed with hepatic abscesses treated at 108 Military Central Hospital from January 2018 to August 2023. The average age of the individuals in the study was 57.8 ± 16.0 years, with a male-to-female ratio of 3.1/1. Frequently associated comorbidities included diabetes mellitus (28.1%), hypertension (14.3%), and gallstones (7.8%). Epidemiological risk factors within the study population encompassed irregular deworming practices (99%), consumption of raw vegetables (49%), intake of raw salads (44.9%), and inadequate hand hygiene following restroom use (44.9%). The classic Fontan's triad was identified in 26% of patients. Among the 196 patients, 57.15% exhibited anemia, 70.9% displayed an elevated white blood cell count (with 73% indicating an increase in neutrophil counts and 26.0% showing an elevation in eosinophil counts), and 98.2% had elevated procalcitonin levels. Liver abscesses were predominantly situated in the right lobe (74.0%), primarily as solitary abscesses (82.6%), with an average size of 63.3 ± 29.1mm, and the largest documented abscess measured 172mm. Bacterial isolates were detected in 63 patients, with Klebsiella being the most prevalent (80.9%), followed by E. coli (7.9%). Conclusion: Typically found in elderly individuals with underlying diseases, and directly related to unsanitary lifestyle habits. The primary cause is Gram-negative bacteria, and imaging diagnosis is an effective diagnostic tool.