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SURGICAL WEBSITES             KIDNEY SURGERY         POSTGRADUATE SURGERY LINKS 

BREAST DISEASE     Breast cancer Breast lump Breast awareness Breast calcifications  Breast cysts Breast pain Duct ectasia Fat necrosis Fibroadenoma Hyperplasia Intraductal papilloma Phyllodes tumour Sclerosing adenosis                                                                                                                                                 

LIVER ABSCESS      Anatomy of liver Physiology of liver Method of examination of liver Haematology of liver disease. Amoebic liver abscess .Pyogenic liver abscess. Percutaneous needle aspiration of liver abscess. Case study.  Result Result continued  Discussion                                                                 

CHOLECYSTECTOMY    Introduction   Historical Review  Anatomy of Gallbladder Physiology of Gallbladder Physiologic effects of pneumoperitoneum Pathology  of Gallbladder Investigations Pre- operative preparation of laparoscopic cholecystectomy Contraindications  Treatment modalities for gallstones.  Anaesthesia                                                                                                                       

INGUINAL HERNIA    HOW SURGICAL OPERATION IS DONE     THYROID EXAMINATION MANAGEMENT OF SEVERELY INJURED PATIENT      SEPSIS AND MULTIPLE ORGAN FAILURE CHEST TRAUMA     BRONCHOGENIC CARCINOMA     TETANUS AND ANAEROBIC INFECTIONS 

 

 

 

Sr no	Laboratory investigations	No of patients
1	Haemoglobin <12gm/dl	17
2	White cell count >11000 * 109/l	80
3	Alkaline phosphatase >300 units/l	78
4	g-Glutamyl transpeptidase > 50units/l	37
5	S.G.P.T. >40units/l	35
6	Serum amylase >220units	10
7	Bilirubin > 1mg%	44

 

Table II. Abnormal laboratory findings in the patients with liver abscess at the time of diagnosis.

 

 

 

 

 

 

S No	Comparison criteria	Group 1	Group 2
	Type of management required
1	Conservative	15	2
2	Percutaneous drainage Once	26	3
3	Percutaneous drainage Twice	18	5
4	Percutaneous drainage Multipe	19	9
5	Open surgical drainage	0	11
	Morbidity and mortality
1	Shock	0	10
2	Mortality	0	6

 

 

Table III. Table comparing Group 1 and Group 2 in terms of management offered morbidity and morality.

 

 

 

 

Sr No	Infecting organism	Pyogenic abscess	Superadded infection on amoebic abscess
	Aerobes
	Gram +ve
1	Staphylococcus	7	4
2	Streptococcus	4	3
3	Enterococcus	1
	Gram –ve
4	E. coli	4	3
5	Pseudomonas	1
6	Klebsiella	1	1
7	Salmonella	2
	Anaerobes
	Gram +ve
8	Clostridium		1
	Gram –ve
9	Bacteroides	1

 

Table IV. Infecting organisms responsible for pyogenic abscess and for infection superaddding on pyogenic abscess in 17 patients pyogenic in group and in 12 patients with super added bacterial infection on amoebic liver abscess. It also includes patients with poly-microbial infections.

 

 

 

Sr No	Aetiology of pyogenic liver abscess	No of patients
I	Biliary
a	Cholangiocarcinoma	1
b	Choledocholithiasis/ cholangitis	4
c	Bile duct injury, prolonged T tube placement	1
II	Hepatic
a	Infected metastasis	2
III	Local extension
a	Empyaema of gallbladder	2
IV	Portal
a	Diverticular disease	1
V	Chronic pancreatitis	2
VI	Chemotherapy	1
VII	Long term steroids	1
VIII	Iatrogenic/ liver biopsy	1
IX	Idiopathic	1

 

Table V. Aetiology of pyogenic liver abscess.

 

 

 

GRAPH I. SHOWING MALE AND FEMALE PATIENTS.

 GRAPH II.  INVESTIGATIONS OF THE PATIENTS PRESENTING

                      WITH LIVER ABSCESS

 

GRAPH III. SHOWING IMPORTANT PRESENTING SIGN AND SYMPTOMS.

 

GRAPH IV. SHOWING AMOEBIC VERSUS PYOGENIC LIVER ABSCESS.

 

GRAPH V. SHOWING COMPARISON BETWEEN GROUP 1 & 2.