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What Do These Following Lab Reports Indicate?
Question: My father (67 years) is recently diagnosed with four liver abscess, measuring 7.9X6.1 cm and 8.8X4.7 cm . Pfa reports of sonography, CT scan, Blood report, ascitic fluid report and chest x ray report (2 days : 21/11/16 and 22/11/16 ). Doctors have performed needle aspiration as of now, and pus is sent for culture tests.
12 ml of pus has come out , red in colour. Please suggest if pigtail was necessary (as suggested by other doctors,in second opinion, who recommended it was absolutely necessary for early relief ) and what are the immediate steps to be observed apart from giving antibiotics. There is an abnormal leukocyte increase 80,000 today. Should we get highly alert and shift him to some other hospital ?
Note : Blood sugar level during admission was 155, which reduced to 118 now
12 ml of pus has come out , red in colour. Please suggest if pigtail was necessary (as suggested by other doctors,in second opinion, who recommended it was absolutely necessary for early relief ) and what are the immediate steps to be observed apart from giving antibiotics. There is an abnormal leukocyte increase 80,000 today. Should we get highly alert and shift him to some other hospital ?
Note : Blood sugar level during admission was 155, which reduced to 118 now
Brief Answer:
Await a Culture report done
Detailed Answer:
Hi
Thanks for writing in
Do not panic
Aspiration is the primary treatment but as the abcess has ruptured ? there are chances of getting peritonitis
I would keep a close watch on vital parameters, daily counts and alternate day ultrasound
A pigtail would have helped in the sense that it would have drained the left over or newly formed pus
The count 80000 is in the peritoneal fluid I would rely on CBC
As suggested observe for another 24 hours or so if he stabilizes no need to worry but if he doesn't or deteriorates take a second opinion
Hope this helps
Do write back in case of concern
Await a Culture report done
Detailed Answer:
Hi
Thanks for writing in
Do not panic
Aspiration is the primary treatment but as the abcess has ruptured ? there are chances of getting peritonitis
I would keep a close watch on vital parameters, daily counts and alternate day ultrasound
A pigtail would have helped in the sense that it would have drained the left over or newly formed pus
The count 80000 is in the peritoneal fluid I would rely on CBC
As suggested observe for another 24 hours or so if he stabilizes no need to worry but if he doesn't or deteriorates take a second opinion
Hope this helps
Do write back in case of concern
Above answer was peer-reviewed by :
Dr. Yogesh D
Hi Doctor,
one of the abcess(out of 4) had ruptured due to which needle aspiration was done. But still the swelling is there.
1) Can cleaning be done to prevent peritonitis? Has it to be done with surgery only (as the doctors are suggesting there) or can surgery be avoided?
2) The swelling is still there, so are there chances for rupture of second abcess?
3)The current WBC count is 14300, and no fever till now (calpol is being given)
4)Please suggest what can be the possible treatment now? (Kindly also tell what all reports that you want and any specific testing that you want to suggest?)
one of the abcess(out of 4) had ruptured due to which needle aspiration was done. But still the swelling is there.
1) Can cleaning be done to prevent peritonitis? Has it to be done with surgery only (as the doctors are suggesting there) or can surgery be avoided?
2) The swelling is still there, so are there chances for rupture of second abcess?
3)The current WBC count is 14300, and no fever till now (calpol is being given)
4)Please suggest what can be the possible treatment now? (Kindly also tell what all reports that you want and any specific testing that you want to suggest?)
Brief Answer:
Might need surgery
Detailed Answer:
Hi
Looking at the current scenario and the reports attached
I would suggest :
1] Open or laparoscopic surgery with peritoneal lavage
2] Always there but with good antibiotics may regress
3] WBC will start reducing gradually, get counts done every third day
4] Peritoneal lavage followed by higher antibiotics
Hope this clears your doubts
Do write back in case of concern
Might need surgery
Detailed Answer:
Hi
Looking at the current scenario and the reports attached
I would suggest :
1] Open or laparoscopic surgery with peritoneal lavage
2] Always there but with good antibiotics may regress
3] WBC will start reducing gradually, get counts done every third day
4] Peritoneal lavage followed by higher antibiotics
Hope this clears your doubts
Do write back in case of concern
Note: For further follow up on digestive issues share your reports here and Click here.
Above answer was peer-reviewed by :
Dr. Prasad
Answered by
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