Background: Amoebic liver abscess is an important cause of inflammatory space occupying lesion of liver. 0It is a common condition in India; a serious problem and associated with higher morbidity and mortality; if not managed properly. This study is conducted to know the clinical presentation, management and efficacy of conservative management and percutaneous aspiration in amoebic liver abscess.
Materials and Methods: A total of 30 patients of amoebic liver abscess were selected for the study in Vydehi Institute of Medical Sciences and research centre, Bangalore. Their clinical presentation, lab findings and treatment in the form of conservative (in abscess less than 5 cms diameter and volume of 125 cm3) and ultrasound guided percutaneous aspiration (in abscess more than 5 cms diameter and volume of
125 cm3 or more) were studied. Results: This study showed that the amoebic liver abscess was more common in low socioeconomic
middle aged male patients. Male to female ratio was 6:1. Mean duration of symptoms 7.5 days in conservative management and 7 days in percutaneous aspiration patients. Pain and fever were the most
common symptoms. USG abdomen was very useful in early diagnosis and assessing prognosis. Most of the abscess was solitary and more common in right lobe of liver. Liver function tests helps in knowing
effectiveness of the treatment and the prognosis. None of the patients were positive for cysts in the stool. All 30 (100%) patients were positive for anti amoebic antibody. Conservative management was more effective in patients with cavities less than 5 cms (125 cm3 volume). Two patients were converted to percutaneous aspiration. Percutaneous aspiration was more effective in patients with cavities more than
5 cms. In none of the cases of amoebic abscess surgical drainage was employed. There was mortality due to complications. Conclusion: The study conclusion includes Amoebic liver abscess is more commonly seen in young to middle aged males. Ultrasonography helps in early
diagnosis and reducing morbidity and mortality. It also confirms the site, size and number of amoebic liver abscess and knowing the prognosis. Liver function tests helps in knowing the effectiveness of the treatment and prognosis. Amoebic liver abscess less than 5 cms are effectively treated by conservative management and abscess more than 5 cms by percutaneous aspiration. Resolution of abscess cavity is faster in patients treated by percutaneous aspiration as compared to conservative treatment, but duration of hospital stay is more in patients treated by percutaneous aspiration due to retained pigtail catheter for drainage for long duration. Metronidazole effective in most of the
amoebic liver abscess.
Keywords: Amoebic; Liver abscess; Metronidazole.