Liver abscess of children in Côte-d’Ivoire: retrospective analysis of a series of 30 cases

Abstract

Objective: The aim of this study was to report the results of liver abscess management in children.

Patients and methods: We conducted a retrospective and descriptive study of 30 cases of liver abscesses collected over 9 years (March 2007 to February 2016). The following variables were studied and results were judged on the clinical and ultrasound follow-up: age, sex, hepatodigestive past history, evolution delay, clinical presentation, size, site, and number of collected pouch, HIV serology, bacteriologic exams, and management modalities.

Results: Our series was made up of 18 boys and 12 girls with a mean age of 5.4 years. A past history of bloody saddles was noted in five cases. Fontan’s triad combining a painful hepatomegaly with fever was observed in 25 patients. The collection was multiple in seven cases. The right lobe was found to be the most affected in 20 (66.7%) cases. The mean diameter was 11.8 cm with extremes ranging from 4 to 18 cm. The amoebic serology was positive in nine (30%) cases and Staphylococcus aureus was found in four cases. Four patients were subjected to an exclusive medical treatment. An ultrasound-guided evacuating puncture and drainage were carried out, respectively, in five and 17 patients. A laparotomy was carried out in four patients, of which two were after secondary abscess rupture. Mortality was nil. No recurrence was recorded with a mean follow-up of 4.5 years.

Conclusion: Liver abscess is not exceptional in the Ivory Coast paediatric hospital environment and constitutes a medicosurgical emergency with a good prognosis whose well-coded management needs to be early.

Keywords: children, liver abscess, management