Salient facts about liver abscesses and hydatid cysts
•Amoebic abscesses do not require aspiration or drainage/treat with AB’s only.
•Pyogenic abscesses are managed with drainage and AB’s. Indications for surgical drainage being failed drainage, multiple abscesses, liver or systemic disease.
•Hydatid cysts are no longer managed by instillation of hypertonic saline, alcohol, etc into the cavity as can cause sclerosing cholangitis. Pack the small bowel away with hypertonic saline soaked packs. Marsupialize the cyst ensuring all daughter cysts are removed. Pack the residual cavity with pedicled omentum.
Sunday, September 30, 2007
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