Popis: |
They predominate between the fifth and sixth decade of life, due to the higher incidence of neoplasms and complex biliary diseases, with higher incidence in countries with temperate climate. Most are secondary to biliary or gastrointestinal tract infection. It is often preceded by symptoms that vary from days to two to three weeks, with fever in 90% of patients, followed by hepatomegaly, attack of the general condition, weight loss, anorexia and vomiting and finally hepatodynia. Mortality rates vary in various series from 5 to 10% in North America and Europe to 3 to 30% worldwide. The difference probably lies in the pathology responsible for the condition. Mortality has been shown to be higher in older patients with multiple comorbidities, including cirrhosis, renal failure, sepsis and cancer. Patients treated with aspiration or percutaneous drainage have half the mortality of those treated with antibiotic therapy alone. |