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Published in: Abdominal Radiology 3/2021

01-03-2021 | Computed Tomography | Hepatobiliary

Multiple septae as potential protective factors against spontaneous pyogenic liver abscess rupture: a propensity score matching analysis

Authors: Hairui Wang, Yue Ren, Zhaoyu Liu, Zhihui Chang

Published in: Abdominal Radiology | Issue 3/2021

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Abstract

Purpose

The symptoms of spontaneous rupture of a pyogenic liver abscess (PLA) are severe and often life-threatening. Multiple septae are important imaging features of PLA. However, the relationship between septation and abscess rupture is still under debate.

Methods

Patients diagnosed with PLA from January 2011 to November 2019 in our hospital were included. We collected demographic, clinical, and computed tomography data. Univariate and multivariate analyses determined liver abscess rupture risk factors. The relationship between multiple septae and abscess rupture was evaluated by propensity score matching after matching other influencing factors.

Results

A total of 583 patients of pyogenic liver abscesses were included in the study: 30 ruptured and 553 unruptured. Multivariate analysis revealed diabetes, single lesion, gas formation, left hepatic lobe location, and a diameter > 66.5 mm as independent risk factors for ruptures, while multiple septae were identified as a protective factor. After matching all the influencing factors (excluding multiple septae), multiple septae and abscess rupture maintain a negative relationship.

Conclusions

Multiple septae were identified as a potentially protective factor against spontaneous pyogenic liver abscess ruptures.
Literature
1.
go back to reference Shi SH, Feng XN, Lai MC, Kong HS, et al (2017). Biliary diseases as main causes of pyogenic liver abscess caused by extended-spectrum beta-lactamase-producing Enterobacteriaceae. Liver Int5:727-734.CrossRef Shi SH, Feng XN, Lai MC, Kong HS, et al (2017). Biliary diseases as main causes of pyogenic liver abscess caused by extended-spectrum beta-lactamase-producing Enterobacteriaceae. Liver Int5:727-734.CrossRef
2.
go back to reference Lee IR, Sng E, Lee K-O, Molton JS, et al (2017). Comparison of Diabetic and Non-diabetic Human Leukocytic Responses to Different Capsule Types of Klebsiella pneumoniae Responsible for Causing Pyogenic Liver Abscess. Front Cell Infect Microbiol 7: 401.CrossRef Lee IR, Sng E, Lee K-O, Molton JS, et al (2017). Comparison of Diabetic and Non-diabetic Human Leukocytic Responses to Different Capsule Types of Klebsiella pneumoniae Responsible for Causing Pyogenic Liver Abscess. Front Cell Infect Microbiol 7: 401.CrossRef
3.
go back to reference Mohan BP, Meyyur Aravamudan V, Khan SR, et al (2019). Prevalence of colorectal cancer in cryptogenic pyogenic liver abscess patients. Do they need screening colonoscopy? A systematic review and meta-analysis. Dig Liver Dis12: 1641-1645.CrossRef Mohan BP, Meyyur Aravamudan V, Khan SR, et al (2019). Prevalence of colorectal cancer in cryptogenic pyogenic liver abscess patients. Do they need screening colonoscopy? A systematic review and meta-analysis. Dig Liver Dis12: 1641-1645.CrossRef
4.
go back to reference Garcia-Eulate R, Hussain N, Heller T,et al (2006). CT and MRI of hepatic abscess in patients with chronic granulomatous disease. AJR Am J Roentgenol2:482-490.CrossRef Garcia-Eulate R, Hussain N, Heller T,et al (2006). CT and MRI of hepatic abscess in patients with chronic granulomatous disease. AJR Am J Roentgenol2:482-490.CrossRef
5.
go back to reference Lee CH, Leu HS, Wu TS,et al (2005). Risk factors for spontaneous rupture of liver abscess caused by Klebsiella pneumoniae. Diagn Microbiol Infect Dis2:79-84.CrossRef Lee CH, Leu HS, Wu TS,et al (2005). Risk factors for spontaneous rupture of liver abscess caused by Klebsiella pneumoniae. Diagn Microbiol Infect Dis2:79-84.CrossRef
6.
go back to reference Jun CH, Yoon JH, Wi JW, et al(2015). Risk factors and clinical outcomes for spontaneous rupture of pyogenic liver abscess. J Digest Dis 1:31-36.CrossRef Jun CH, Yoon JH, Wi JW, et al(2015). Risk factors and clinical outcomes for spontaneous rupture of pyogenic liver abscess. J Digest Dis 1:31-36.CrossRef
7.
go back to reference Kim S-B, Je B-K, Lee KY, et al (2007). Computed tomographic differences of pyogenic liver abscesses caused by Klebsiella pneumoniae and non-Klebsiella pneumoniae. J Comput Assist Tomo 1:59-65.CrossRef Kim S-B, Je B-K, Lee KY, et al (2007). Computed tomographic differences of pyogenic liver abscesses caused by Klebsiella pneumoniae and non-Klebsiella pneumoniae. J Comput Assist Tomo 1:59-65.CrossRef
8.
go back to reference Lin YT, Wang FD, Wu PF, et al (2013). Klebsiella pneumoniae liver abscess in diabetic patients: association of glycemic control with the clinical characteristics. BMC Infect Dis 13:56.CrossRef Lin YT, Wang FD, Wu PF, et al (2013). Klebsiella pneumoniae liver abscess in diabetic patients: association of glycemic control with the clinical characteristics. BMC Infect Dis 13:56.CrossRef
9.
go back to reference Cheng HC, Chang WL, Chen WY, , et al (2008). Long-term outcome of pyogenic liver abscess: factors related with abscess recurrence. J Clin Gastroenterol10:1110-1115.CrossRef Cheng HC, Chang WL, Chen WY, , et al (2008). Long-term outcome of pyogenic liver abscess: factors related with abscess recurrence. J Clin Gastroenterol10:1110-1115.CrossRef
10.
go back to reference Zhu X, Wang S, Jacob R, Fan Z, et al (2011). A 10-year retrospective analysis of clinical profiles, laboratory characteristics and management of pyogenic liver abscesses in a chinese hospital. Gut Liver2:221-227.CrossRef Zhu X, Wang S, Jacob R, Fan Z, et al (2011). A 10-year retrospective analysis of clinical profiles, laboratory characteristics and management of pyogenic liver abscesses in a chinese hospital. Gut Liver2:221-227.CrossRef
11.
go back to reference Lai HC, Lin HC (2010). Cryptogenic pyogenic liver abscess as a sign of colorectal cancer: a population-based 5-year follow-up study. Liver Int 9:1387-1393.CrossRef Lai HC, Lin HC (2010). Cryptogenic pyogenic liver abscess as a sign of colorectal cancer: a population-based 5-year follow-up study. Liver Int 9:1387-1393.CrossRef
12.
go back to reference Li C, Li G, Miao R, Lu X, et al (2012). Primary liver cancer presenting as pyogenic liver abscess: characteristics, diagnosis, and management. J Surg Oncol7:687-691.CrossRef Li C, Li G, Miao R, Lu X, et al (2012). Primary liver cancer presenting as pyogenic liver abscess: characteristics, diagnosis, and management. J Surg Oncol7:687-691.CrossRef
13.
go back to reference Li J, Huang L, Liu CF, et al (2014). Risk factors and surgical outcomes for spontaneous rupture of BCLC stages A and B hepatocellular carcinoma: a case-control study. World J Gastroenterol 27:9121-9127. Li J, Huang L, Liu CF, et al (2014). Risk factors and surgical outcomes for spontaneous rupture of BCLC stages A and B hepatocellular carcinoma: a case-control study. World J Gastroenterol 27:9121-9127.
14.
go back to reference Williamson EJ, Forbes A (2014). Introduction to propensity scores. Respirology5:625-635.CrossRef Williamson EJ, Forbes A (2014). Introduction to propensity scores. Respirology5:625-635.CrossRef
15.
go back to reference Escorsell A, Bordas JM, Feu F, et al (1997). Endoscopic assessment of variceal volume and wall tension in cirrhotic patients: effects of pharmacological therapy. Gastroenterology5:1640-1646.CrossRef Escorsell A, Bordas JM, Feu F, et al (1997). Endoscopic assessment of variceal volume and wall tension in cirrhotic patients: effects of pharmacological therapy. Gastroenterology5:1640-1646.CrossRef
16.
go back to reference Liao WI, Tsai SH, Yu CY, et al (2012). Pyogenic liver abscess treated by percutaneous catheter drainage: MDCT measurement for treatment outcome. Eur J Radiol4:609-615.CrossRef Liao WI, Tsai SH, Yu CY, et al (2012). Pyogenic liver abscess treated by percutaneous catheter drainage: MDCT measurement for treatment outcome. Eur J Radiol4:609-615.CrossRef
17.
go back to reference Wang HH, Tsai SH, Yu CY, et al (2014).The association of haemoglobin A(1)C levels with the clinical and CT characteristics of Klebsiella pneumoniae liver abscesses in patients with diabetes mellitus. European radiology5:980-989.CrossRef Wang HH, Tsai SH, Yu CY, et al (2014).The association of haemoglobin A(1)C levels with the clinical and CT characteristics of Klebsiella pneumoniae liver abscesses in patients with diabetes mellitus. European radiology5:980-989.CrossRef
18.
go back to reference Chang Z, Wang H, Li B, et al (2018). Metabolic Characterization of Peripheral Host Responses to Drainage-Resistant Klebsiella pneumoniae Liver Abscesses by Serum 1H-NMR Spectroscopy. Front Cell Infect Microbiol 8:174.CrossRef Chang Z, Wang H, Li B, et al (2018). Metabolic Characterization of Peripheral Host Responses to Drainage-Resistant Klebsiella pneumoniae Liver Abscesses by Serum 1H-NMR Spectroscopy. Front Cell Infect Microbiol 8:174.CrossRef
19.
go back to reference Liu CH, Gervais DA, Hahn PF, et al (2009). Percutaneous hepatic abscess drainage: do multiple abscesses or multiloculated abscesses preclude drainage or affect outcome? J Vasc Interv Radiol8:1059-1065.CrossRef Liu CH, Gervais DA, Hahn PF, et al (2009). Percutaneous hepatic abscess drainage: do multiple abscesses or multiloculated abscesses preclude drainage or affect outcome? J Vasc Interv Radiol8:1059-1065.CrossRef
20.
go back to reference Chang Z, Ma Y, Liu Z, et al (2015). Analysis of clinical and CT characteristics of patients with Klebsiella pneumoniae liver abscesses: an insight into risk factors of metastatic infection. IJID 33:50-54.PubMed Chang Z, Ma Y, Liu Z, et al (2015). Analysis of clinical and CT characteristics of patients with Klebsiella pneumoniae liver abscesses: an insight into risk factors of metastatic infection. IJID 33:50-54.PubMed
21.
go back to reference Mortelé KJ, Segatto E, Ros PR (2004). The infected liver: radiologic-pathologic correlation. Radiographic 4:937-955.CrossRef Mortelé KJ, Segatto E, Ros PR (2004). The infected liver: radiologic-pathologic correlation. Radiographic 4:937-955.CrossRef
22.
go back to reference Ceydeli A, Condon MR, Siegel JH (2003). The septic abscess wall: a cytokine-generating organ associated with portal venous cytokinemia, hepatic outflow fibrosis, sinusoidal congestion, inflammatory cell sequestration, hepatocellular lipid deposition, and focal cell death. Shock1:74-84.CrossRef Ceydeli A, Condon MR, Siegel JH (2003). The septic abscess wall: a cytokine-generating organ associated with portal venous cytokinemia, hepatic outflow fibrosis, sinusoidal congestion, inflammatory cell sequestration, hepatocellular lipid deposition, and focal cell death. Shock1:74-84.CrossRef
23.
go back to reference Fang CT, Chuang YP, Shun CT, et al (2004). A novel virulence gene in Klebsiella pneumoniae strains causing primary liver abscess and septic metastatic complications. J Exp Med :697-705.CrossRef Fang CT, Chuang YP, Shun CT, et al (2004). A novel virulence gene in Klebsiella pneumoniae strains causing primary liver abscess and septic metastatic complications. J Exp Med :697-705.CrossRef
24.
go back to reference de Stoppelaar SF, Claushuis TAM, Jansen MPB, et al (2015). The role of platelet MyD88 in host response during gram-negative sepsis. J Thromb Haemost9:1709-1720.CrossRef de Stoppelaar SF, Claushuis TAM, Jansen MPB, et al (2015). The role of platelet MyD88 in host response during gram-negative sepsis. J Thromb Haemost9:1709-1720.CrossRef
Metadata
Title
Multiple septae as potential protective factors against spontaneous pyogenic liver abscess rupture: a propensity score matching analysis
Authors
Hairui Wang
Yue Ren
Zhaoyu Liu
Zhihui Chang
Publication date
01-03-2021
Publisher
Springer US
Published in
Abdominal Radiology / Issue 3/2021
Print ISSN: 2366-004X
Electronic ISSN: 2366-0058
DOI
https://doi.org/10.1007/s00261-020-02758-2

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