Experience with liver abscess.

One hundred ninety-two liver abscesses in 190 patients were treated: 109 by needle aspiration, and 83 by operation. Mortality and complication rates were lower in the aspiration group, and the average hospital stay was shorter. This was true for both pyogenic and sterile abscesses, the latter being presumed to be amebic, although trophozoites were recovered from liver pus in only two patients. Patients with pyogenic abscess were, on the average, considerably younger than patients with the condition in the United States for reasons that are not immediately apparent. The preponderance of amebic abscesses found in men is less than usual, again for reasons that are not clear. Both pyogenic and amebic abscesses were commonly associated with fever, chills, and tenderness and pain in the right upper abdomen and hepatomegaly on physical examination. We found metronidazole effective in the treatment of both pyogenic and amebic abscesses.