Characteristics and Treatment Outcome of Liver Abscesses: An Observational Study

NCT ID: NCT06852235

Last Updated: 2025-02-28

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

NOT_YET_RECRUITING

Total Enrollment

70 participants

Study Classification

OBSERVATIONAL

Study Start Date

2025-03-15

Study Completion Date

2027-06-01

Brief Summary

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1. To assess the frequency, clinical presentation, microbiological and radiological characteristics of liver abscesses.
2. To evaluate the management plan and treatment outcome of liver abscess.
3. To study risk factors of liver abscess.

Detailed Description

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There is a paucity of information on liver abscesses' epidemiology and characteristics in the Middle East in general and Egypt in particular.

The incidence of liver abscess varies from one country to another. The annual incidence of pyogenic liver abscess has been estimated at 2.3 cases per 100,000 populations and 18-20 per 100 000 hospital admissions (Mohsen et al 2002, Kaplan et al 2004).

Liver abscess is a potentially life-threatening condition (Ahmed et al., 2016).

A review by Chan KS et al. of 16 pyogenic LA (PLA) articles showed mortality rates ranging from 0% to 15.7 % (Chan et al., 2022).

The etiology of LA can be bacterial (most often polymicrobial), parasitic (amebic essentially), mixed (pyogenic superinfection of parasitic abscess) or more rarely fungal (Nakanishi et al., 2009).

Microbes can invade the liver parenchyma by way of the bile ducts, blood stream (hematogenic, most often portal), or by contiguous spread, especially via the gallbladder bed (Yoo et al., 1993, Thomsen et al., 2007).

Advanced age, diabetes mellitus (DM) and the presence of underlying malignancy are considered major risk factors, and the latter is associated with a worse prognosis (Yoo et al., 1993, Thomsen et al., 2007).

The number of cryptogenic liver abscess cases has been on the rise, and no predisposing conditions (cryptogenic) was reported in 18% (McNeil et al. 2020).

The diagnosis of LA relies essentially on imaging. Sonography and CT scan lead to diagnosis in more than 90% of cases (Halvorsen et al., 1984).

Conditions

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Liver Abscess

Study Design

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Observational Model Type

OTHER

Study Time Perspective

CROSS_SECTIONAL

Eligibility Criteria

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Inclusion Criteria

* Diagnosis of LA will be based on typical appearance on ultrasound (US) or computed tomography (CT) of abdomen with clinical features consistent with the diagnosis (fever, chills, jaundice, right upper quadrant pain/epigastric discomfort).
* US or CT-guided aspiration of pus from a hepatic lesion.
* Complete resolution of radiological abnormalities following antimicrobial therapy.

Exclusion Criteria

* Liver abscess that occurs secondary to hydatid cyst.
* Liver abscess associated with underlying malignancy.
* Patient with incomplete medical records.
Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Assiut University

OTHER

Sponsor Role lead

Responsible Party

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Marco Magdy Wadie

Resident at Police Hospital

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Ashraf Mahmoud Othman, doctorate

Role: STUDY_DIRECTOR

Assiut University

Haidi Karam-Allah Ramadan, doctorate

Role: STUDY_DIRECTOR

Assiut University

Central Contacts

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Marco Magdy, Bachelor

Role: CONTACT

Phone: 01270777143

Email: [email protected]

References

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Ahmed S, Chia CL, Junnarkar SP, Woon W, Shelat VG. Percutaneous drainage for giant pyogenic liver abscess--is it safe and sufficient? Am J Surg. 2016 Jan;211(1):95-101. doi: 10.1016/j.amjsurg.2015.03.002. Epub 2015 May 7.

Reference Type BACKGROUND
PMID: 26033361 (View on PubMed)

Alkofer B, Dufay C, Parienti JJ, Lepennec V, Dargere S, Chiche L. Are pyogenic liver abscesses still a surgical concern? A Western experience. HPB Surg. 2012;2012:316013. doi: 10.1155/2012/316013. Epub 2012 Feb 19.

Reference Type BACKGROUND
PMID: 22536008 (View on PubMed)

Baban FA. Clinical characteristic of amoebic liver abscesses in the North of Iraq. Saudi Med J. 2000 Jun;21(6):545-9.

Reference Type BACKGROUND
PMID: 11500703 (View on PubMed)

Ballas ZK, Uthman SM. Amebic liver abscess in Lebanon. A report of 37 cases and a review of the literature. Am J Proctol. 1973 Jun;24(3):228-36. No abstract available.

Reference Type BACKGROUND
PMID: 4707978 (View on PubMed)

Chan KS, Chia CTW, Shelat VG. Demographics, Radiological Findings, and Clinical Outcomes of Klebsiella pneumonia vs. Non-Klebsiella pneumoniae Pyogenic Liver Abscess: A Systematic Review and Meta-Analysis with Trial Sequential Analysis. Pathogens. 2022 Aug 26;11(9):976. doi: 10.3390/pathogens11090976.

Reference Type BACKGROUND
PMID: 36145408 (View on PubMed)

Chiche L, Dargere S, Le Pennec V, Dufay C, Alkofer B. [Pyogenic-liver abscess: diagnosis and management]. Gastroenterol Clin Biol. 2008 Dec;32(12):1077-91. doi: 10.1016/j.gcb.2008.09.019. Epub 2008 Nov 18. French.

Reference Type BACKGROUND
PMID: 19019604 (View on PubMed)

Dellinger RP, Levy MM, Rhodes A, Annane D, Gerlach H, Opal SM, Sevransky JE, Sprung CL, Douglas IS, Jaeschke R, Osborn TM, Nunnally ME, Townsend SR, Reinhart K, Kleinpell RM, Angus DC, Deutschman CS, Machado FR, Rubenfeld GD, Webb SA, Beale RJ, Vincent JL, Moreno R; Surviving Sepsis Campaign Guidelines Committee including the Pediatric Subgroup. Surviving sepsis campaign: international guidelines for management of severe sepsis and septic shock: 2012. Crit Care Med. 2013 Feb;41(2):580-637. doi: 10.1097/CCM.0b013e31827e83af.

Reference Type BACKGROUND
PMID: 23353941 (View on PubMed)

Halvorsen RA, Korobkin M, Foster WL, Silverman PM, Thompson WM. The variable CT appearance of hepatic abscesses. AJR Am J Roentgenol. 1984 May;142(5):941-6. doi: 10.2214/ajr.142.5.941.

Reference Type BACKGROUND
PMID: 6372412 (View on PubMed)

Huang CJ, Pitt HA, Lipsett PA, Osterman FA Jr, Lillemoe KD, Cameron JL, Zuidema GD. Pyogenic hepatic abscess. Changing trends over 42 years. Ann Surg. 1996 May;223(5):600-7; discussion 607-9. doi: 10.1097/00000658-199605000-00016.

Reference Type BACKGROUND
PMID: 8651751 (View on PubMed)

Kaplan GG, Gregson DB, Laupland KB. Population-based study of the epidemiology of and the risk factors for pyogenic liver abscess. Clin Gastroenterol Hepatol. 2004 Nov;2(11):1032-8. doi: 10.1016/s1542-3565(04)00459-8.

Reference Type BACKGROUND
PMID: 15551257 (View on PubMed)

Liu L, Chen W, Lu X, Zhang K, Zhu C. Pyogenic Liver Abscess: A Retrospective Study of 105 Cases in an Emergency Department from East China. J Emerg Med. 2017 Apr;52(4):409-416. doi: 10.1016/j.jemermed.2016.09.026. Epub 2016 Oct 17.

Reference Type BACKGROUND
PMID: 27765437 (View on PubMed)

McNeil T, Daniel S, Gordon DL. Management of pyogenic liver abscess: a South Australian experience. ANZ J Surg. 2020 Nov;90(11):2274-2278. doi: 10.1111/ans.15963. Epub 2020 May 26.

Reference Type BACKGROUND
PMID: 32455495 (View on PubMed)

Mohsen AH, Green ST, Read RC, McKendrick MW. Liver abscess in adults: ten years experience in a UK centre. QJM. 2002 Dec;95(12):797-802. doi: 10.1093/qjmed/95.12.797.

Reference Type BACKGROUND
PMID: 12454322 (View on PubMed)

Mousa H, Al-Bluwi GSM, Al Drini ZFM, Gasmelseed HI, Alkoteesh JA, Babiker ZOE. Importation of Entamoeba histolytica and predominance of Klebsiella pneumoniae in liver abscesses: a 7-year retrospective cohort study from the United Arab Emirates. Trop Dis Travel Med Vaccines. 2021 Jun 12;7(1):17. doi: 10.1186/s40794-021-00140-8.

Reference Type BACKGROUND
PMID: 34118991 (View on PubMed)

Mucke MM, Kessel J, Mucke VT, Schwarzkopf K, Hogardt M, Stephan C, Zeuzem S, Kempf VAJ, Lange CM. The role of Enterococcus spp. and multidrug-resistant bacteria causing pyogenic liver abscesses. BMC Infect Dis. 2017 Jun 26;17(1):450. doi: 10.1186/s12879-017-2543-1.

Reference Type BACKGROUND
PMID: 28651522 (View on PubMed)

Nakanishi Y, Kayahara T, Yamashita Y, Okuno M, Nakamura F, Taniguchi Y, Inoue N, Nakatani Y, Hatamaru K, Shimizu T, Tanaka A, Yoshioka T, Seta T, Urai S, Uenoyama Y. [A case of ruptured giant liver cyst complicated by Candida infection]. Nihon Shokakibyo Gakkai Zasshi. 2009 Jul;106(7):1056-62. Japanese.

Reference Type BACKGROUND
PMID: 19578314 (View on PubMed)

Solomkin JS, Mazuski JE, Bradley JS, Rodvold KA, Goldstein EJ, Baron EJ, O'Neill PJ, Chow AW, Dellinger EP, Eachempati SR, Gorbach S, Hilfiker M, May AK, Nathens AB, Sawyer RG, Bartlett JG. Diagnosis and management of complicated intra-abdominal infection in adults and children: guidelines by the Surgical Infection Society and the Infectious Diseases Society of America. Surg Infect (Larchmt). 2010 Feb;11(1):79-109. doi: 10.1089/sur.2009.9930.

Reference Type BACKGROUND
PMID: 20163262 (View on PubMed)

Thomsen RW, Jepsen P, Sorensen HT. Diabetes mellitus and pyogenic liver abscess: risk and prognosis. Clin Infect Dis. 2007 May 1;44(9):1194-201. doi: 10.1086/513201. Epub 2007 Mar 28.

Reference Type BACKGROUND
PMID: 17407038 (View on PubMed)

Yoo HM, Kim WH, Shin SK, Chun WH, Kang JK, Park IS. The changing patterns of liver abscess during the past 20 years--a study of 482 cases. Yonsei Med J. 1993 Dec;34(4):340-51. doi: 10.3349/ymj.1993.34.4.340.

Reference Type BACKGROUND
PMID: 8128739 (View on PubMed)

Other Identifiers

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Liver abscess

Identifier Type: -

Identifier Source: org_study_id