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December 1993

Invited Commentary

Author Affiliations

Los Angeles, Calif

Arch Surg. 1993;128(12):1364. doi:10.1001/archsurg.1993.01420240072013

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The management of pyogenic liver abscess has been remarkably altered by the use of ultrasound or computed tomography to identify the abscess and by percutaneous drainage rather than open surgical drainage to treat the majority of such abscesses. In most surgical practices, the majority of pyogenic abscesses result from biliary tract disease or enteric infections. This report is interesting in that it reviews hepatic abscesses that occurred in 37 patients under treatment at the National Cancer Institute for a variety of solid or hematologic malignancies. Seventeen patients had bacterial abscesses, but of greater interest are the 20 patients with fungal abscesses—an entity not commonly encountered in surgical practice. The authors have nicely collated the clinical differences in the two groups of patients and point out that fungal abscesses occur predominantly in patients with hematologic malignancies who are receiving chemotherapy.

The authors stress the diagnostic criteria, the role of ultrasound and

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