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간농양의 임상적 고찰 Clinical Study of Liver Abscess

대한외과학회지 1973년 15권 9호 p.15 ~ 23
김홍균, 민병철,
소속 상세정보
김홍균 (  ) 
서울적십자병원 일반외과

민병철 (  ) 
서울대학교 대학원 외과교수

Abstract


In spite of vast advance made in the field of medicine, especially in chemotherapeutics end antibiotics, abscess of the liver remains as one of the serious and disastrous diseases in Korea mainly because of abuse of- antibiotics.
The incidence, and mortality rate of hepatic abscess had been decreased markedly until 1950, but has become rather stationary for the past 20 years, suggesting certain changes in clinical behavier of the diseases.
This study is a review of the records of 55 patients in whom diagnosis of hepatic abscess was made at Seoul Red Cross Hospital during the period of 4 years from April, 1968 to July, 1972. The results are followings:
1. The incidence of the hepatic abscess was estimated as 0. 247% of total hospital admission according to this present review.
2. Among 55 cases of hepatic abscess, 31 (56. 4%) were considered to be amebic abscess and remaining 24 (43.6%) were pyogenic.
3. The sex ratio was male to female in 1.8 : 1, peak age incidence being 5th decade.
4. The most common clinical manifestations were chill and fever, pain and tenderness on involved lesion.
5. Chest X-ray findings were helpful in making diagnosis in 78% of total patients.
6. Liver scanning showed cold or cool area in 83.3%, making this approach most valuable in clinical evaluation.
7. The most common causative microorganism in pyogenic abscess was E. coli (37.5%) and the most common antecedent lesion was associated with biliary tract infection.
8. In the amebic abscesses, ameba was found in the pus by 16. 1%, and its cyst was seen in 12.9% at stool examinations.
9. Exploratory laparotomy was performed in 30.9% in both groups, cholecystectomy and cholecystostomy were also performed in two patients.
10. The mortality rate was 10. 9% in total series, 6.5% in amebic abscess and, 16. 7% in pyogenic abscess.

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