~ 197 ~ International Journal of Surgery Science 2021; 5(1): 197-200 E-ISSN: 2616-3470 P-ISSN: 2616-3462 © Surgery Science www.surgeryscience.com 2021; 5(1): 197-200 Received: 11-11-2020 Accepted: 17-12-2020 Dr. Shailesh K Rathod Department of Surgery, Zydus Medical College and Hospital, Dahod, Gujarat, India Dr. Shailesh Parmar Department of Surgery, Zydus Medical College and Hospital, Dahod, Gujarat, India Dr. Surendra Parmar Department of Surgery, Zydus Medical College and Hospital, Dahod, Gujarat, India Dr. Asit R Sahu Department of Pharmaceutics, Pioneer Pharmacy Degree College, Vadodara, Gujarat, India Corresponding Author: Dr. Asit R Sahu Department of Pharmaceutics, Pioneer Pharmacy Degree College, Vadodara, Gujarat, India Ultra-sonography guided pigtail placement for drainage of liver abscess in 40 patients: A retrospective study Dr. Shailesh K Rathod, Dr. Shailesh Parmar, Dr. Surendra Parmar and Dr. Asit R Sahu DOI: https://doi.org/10.33545/surgery.2021.v5.i1d.612 Abstract Aim and Objective: 1. To evaluate the advantages of USG guided pigtail catheter placement for drainage of liver abscess. 2. To assess the morbidity and complications of percutaneous pigtail catheter drainage in treatment of liver abscess. Methods: The study was conducted at Zydus Medical College and Hospital, Dahod, Gujarat, January 2018 to January 2020. It included 40 USG confirm cases of liver abscess. The liver Abscess ≥5x5 cm underwent percutaneous drainage was determined by doing serial USG scans. Results: Age group varied from 20 to 60 years. Out of 40 patients 36 were men and 4 were women. The male to female ratio 10:1. 28 patients had solitary abscess, while 12 had multiple abscess. Pigtail catheter of various sizes (10 F or 12 F) were introduced in these patients using the Seldinger technique. The volume of pus drained ranged from 150 to 400 ml, complications were minor and included catheter blockage in 8 patients and tract pain in 35 patients. There was no mortality associated with this procedure. This study shows a success rate of 96%. One patient required repeat pigtail placement after 6 months for recurrent liver abscesses. Conclusion: This study concludes that drainage of liquefied moderate to large sized liver abscess by USG guided pigtail placement as a minimally invasive procedure with low morbidity and mortality and should be first line of management of liver abscesses. Keywords: Liver abscess, pigtail catheter, percutaneous drainage Introduction A liver abscess is a suppurative cavity in the liver resulting from the invasion and multiplication of microorganisms, entering directly from an injury through the blood vessels or by the way of the biliary ductal system. Liver abscesses are most commonly due to pyogenic, amoebic or mixed infections. Less commonly these may be fungal in origin. Although amoebic liver abscess occurs more commonly in men between 20 and 40 years of age, but can occur at any age. Approximately 60% are solitary and mainly located in the right lobe of the liver, as a result of the streaming of portal blood flow secondary to the fact that the right lobe is predominantly supplied by the superior mesenteric vein, and because most of the hepatic volume is in the right lobe. When multiple abscesses are present pyogenic or mixed is the most probable type. Patients usually present with a constant dull pain in the right upper quadrant of the abdomen which may be referred to the scapular region or the right shoulder. These patients usually have fever of between 38 0 C and 40 0 C. Liver abscesses, both amoebic and pyogenic, continue to be an important cause of morbidity and mortality in tropical countries [1] . However, recent advances in interventional radiology, intensive care, progress in antibiotics therapy, liberal use of sonography and computerized tomography scanning of the abdomen have led to early diagnosis and treatment of patients with liver abscess, thus improving the patient outcome [2] . Percutaneous drainage of liver abscess has been an important advancement in the treatment of pyogenic liver abscesses. Percutaneous treatment (needle aspiration or catheter drainage) is now a standard management for liver abscesses [3] . It has replaced surgical exploration which now has very limited indications [4] . Needle aspiration is less expensive avoids problems related to catheter care and long-term hospital care. Multiple abscesses can be aspirated through different tracts in the same sitting [5] .