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肝膿瘍의 臨床的 考察 A Clinical Study of Liver Abscess

대한외과학회지 1975년 17권 7호 p.33 ~ 45
고우경, 尹世榮,
소속 상세정보
고우경 (  ) 
조선대학교 의과대학 외과학교실

尹世榮 (  ) 
朝鮮大學校 醫科大學 外科學敎室

Abstract


This clinical report is based on a review of the records of 57 patients with liver abscess that were confirmed by surgical procedures at the Department of Surgery of the Chosun University Hospital during the 4 years from 1971 through 1974.
The results of the study were obtained as follows;
1. The incidence of liver abscess was estimated as 0. 64% of total cases being admitted to this hospital. .
2. Of the 57 cases with proved liver abscess, 24 (42.1 %) were amoebic, 21 (36.8 %) were pyogenic ´arid the remaining 12 (21.1,%) were mixed infection.
3. The peak incidence of age came in the 4th and 5th decade, on the average of 422 years, and the sex incidence was male to female in the ratio of 2.5: 1.
4. The past history, of intestinal amoebiasis was obtained in 45. 8% of the 24 amoebic cases,
in 25. 0% of the 12 mixed infections, and 85. 7% of the 21 pyogenic cases revealed a history of pyogenic infections with predominance of biliary tract disease (43.0% of pyogenic cases):
5. The most common clinical manifestations were right upper abdominal pain, hepatic tend-erness, fever with chillness and hepatic enlargement.
6. The roentgenological findings of the chest were helpful in making diagnosis in 87.7% of the 57 cases.
7. The liver photoscanning was performed in 27 of the 57 cases and its findings were comp-atible with those of operation in 85.2% and the procedures were highly significant during the diagnosis of location of the abscess.
8. The abscess was found to be more commonly located in the anatomical right lobe (73.5%) than in the left (12.2% and in the remains, both lobes (14.3%) were involved.
9. The amoebas were found in only 3 (12.5%) in the stools and in only 4 (16. 7%) in the pus or necrotic tissues among the 24 cases of amoebic abscess.
Positive culture was made in 15(71.4%) of the 21 cases of pyogenic abscess and in 3(25. 0%) of the 12 cases of mixed infection, the most common pathogenic organisms being Staphylococci and E. coli.
10. Complications were observed in 14 (28.6%) of 49 cases treated surgically, and the over-all mortality rate was 10.5 (6 cases) of the total 57 cases; 4.2% (1) in the 24 cases of amoebic, 14.3% (3) in the 21 cases of pyogenic and 16.7% (2) in the 12 cases of mixed infection.

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