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Not yet recruiting NCT06852235

Characteristics and Treatment Outcome of Liver Abscesses: An Observational Study

— Observational Liver Abscess

For patients and families

In plain language

An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.

What is being studied
This is an observational study: the protocol does not assign a study treatment.
Who it may be relevant to
Registry conditions: Liver Abscess. Basic parameters: No limits · All.
What needs checking
Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
Where it takes place
Center list to be confirmed — check the primary protocol.
Next step
Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →

Unsure about the terms? Read our patient guide →

Overview

1. To assess the frequency, clinical presentation, microbiological and radiological characteristics of liver abscesses. 2. To evaluate the management plan and treatment outcome of liver abscess. 3. To study risk factors of liver abscess.

Detailed description

There is a paucity of information on liver abscesses' epidemiology and characteristics in the Middle East in general and Egypt in particular.

The incidence of liver abscess varies from one country to another. The annual incidence of pyogenic liver abscess has been estimated at 2.3 cases per 100,000 populations and 18-20 per 100 000 hospital admissions (Mohsen et al 2002, Kaplan et al 2004).

Liver abscess is a potentially life-threatening condition (Ahmed et al., 2016).

A review by Chan KS et al. of 16 pyogenic LA (PLA) articles showed mortality rates ranging from 0% to 15.7 % (Chan et al., 2022).

The etiology of LA can be bacterial (most often polymicrobial), parasitic (amebic essentially), mixed (pyogenic superinfection of parasitic abscess) or more rarely fungal (Nakanishi et al., 2009).

Microbes can invade the liver parenchyma by way of the bile ducts, blood stream (hematogenic, most often portal), or by contiguous spread, especially via the gallbladder bed (Yoo et al., 1993, Thomsen et al., 2007).

Advanced age, diabetes mellitus (DM) and the presence of underlying malignancy are considered major risk factors, and the latter is associated with a worse prognosis (Yoo et al., 1993, Thomsen et al., 2007).

The number of cryptogenic liver abscess cases has been on the rise, and no predisposing conditions (cryptogenic) was reported in 18% (McNeil et al. 2020).

The diagnosis of LA relies essentially on imaging. Sonography and CT scan lead to diagnosis in more than 90% of cases (Halvorsen et al., 1984).

Primary outcome measures

  • 1. To assess the frequency, clinical picture, microbiological and radiological characteristics of liver abscesses. [Time frame: Baseline]
Secondary outcome measures (2)
  • 2. To evaluate the management plan and treatment outcome of liver abscess. [Time frame: Baseline]
  • 3. To study risk factors of liver abscess. [Time frame: Baseline]

Eligibility criteria

Inclusion criteria

  • Diagnosis of LA will be based on typical appearance on ultrasound (US) or computed tomography (CT) of abdomen with clinical features consistent with the diagnosis (fever, chills, jaundice, right upper quadrant pain/epigastric discomfort).
  • US or CT-guided aspiration of pus from a hepatic lesion.
  • Complete resolution of radiological abnormalities following antimicrobial therapy.

Exclusion criteria

  • Liver abscess that occurs secondary to hydatid cyst.
  • Liver abscess associated with underlying malignancy.
  • Patient with incomplete medical records.

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Study design

Observational model
Other

Study locations

Center list to be confirmed — check the primary protocol.

Publications

  • Ahmed S, Chia CL, Junnarkar SP, Woon W, Shelat VG. Percutaneous drainage for giant pyogenic liver abscess--is it safe and sufficient? Am J Surg. 2016 Jan;211(1):95-101. doi: 10.1016/j.amjsurg.2015.03.002. Epub 2015 May 7. PMID 26033361
  • Alkofer B, Dufay C, Parienti JJ, Lepennec V, Dargere S, Chiche L. Are pyogenic liver abscesses still a surgical concern? A Western experience. HPB Surg. 2012;2012:316013. doi: 10.1155/2012/316013. Epub 2012 Feb 19. PMID 22536008
  • Baban FA. Clinical characteristic of amoebic liver abscesses in the North of Iraq. Saudi Med J. 2000 Jun;21(6):545-9. PMID 11500703
  • Ballas ZK, Uthman SM. Amebic liver abscess in Lebanon. A report of 37 cases and a review of the literature. Am J Proctol. 1973 Jun;24(3):228-36. No abstract available. PMID 4707978
  • Chan KS, Chia CTW, Shelat VG. Demographics, Radiological Findings, and Clinical Outcomes of Klebsiella pneumonia vs. Non-Klebsiella pneumoniae Pyogenic Liver Abscess: A Systematic Review and Meta-Analysis with Trial Sequential Analysis. Pathogens. 2022 Aug 26;11(9):976. doi: 10.3390/pathogens11090976. PMID 36145408
  • Chiche L, Dargere S, Le Pennec V, Dufay C, Alkofer B. [Pyogenic-liver abscess: diagnosis and management]. Gastroenterol Clin Biol. 2008 Dec;32(12):1077-91. doi: 10.1016/j.gcb.2008.09.019. Epub 2008 Nov 18. French. PMID 19019604
  • Dellinger RP, Levy MM, Rhodes A, Annane D, Gerlach H, Opal SM, Sevransky JE, Sprung CL, Douglas IS, Jaeschke R, Osborn TM, Nunnally ME, Townsend SR, Reinhart K, Kleinpell RM, Angus DC, Deutschman CS, Machado FR, Rubenfeld GD, Webb SA, Beale RJ, Vincent JL, Moreno R; Surviving Sepsis Campaign Guidelines Committee including the Pediatric Subgroup. Surviving sepsis campaign: international guidelines PMID 23353941
  • Halvorsen RA, Korobkin M, Foster WL, Silverman PM, Thompson WM. The variable CT appearance of hepatic abscesses. AJR Am J Roentgenol. 1984 May;142(5):941-6. doi: 10.2214/ajr.142.5.941. PMID 6372412

Identifiers

NCT: NCT06852235 · Liver abscess

Primary sources (government registries)

View this study on ClinicalTrials.gov ↗