Amoebic liver abscess is a serious but curable hepatic illness predominantly seen in tropical countries. We describe our experience of clinical presentation, laboratory parameters, radiological findings and treatment strategies. This is a retrospective analysis of 114 patients who were admitted from January 2012 to September 2014 at our centre. The mean age of presentation was 41.7 ± 13.9 years, the majority of patients were male (86.8%) with chronic alcoholism (63.2%). Most of the patients had a solitary right lobe liver abscess. Abdominal pain, fever, tachycardia and hepatomegaly were the most common clinical findings while hypoalbuminaemia, anaemia, leucocytosis and electrolyte imbalance were the most common laboratory abnormalities. A significant number of patients could be managed with antibiotics only (45.6%), percutaneous radiological drainage techniques being an important adjunct in selected cases (percutaneous needle aspiration, 20.2%; percutaneous pigtail catheter drainage, 30.7%). Surgical intervention was required in only a few cases (3.5%). Mortality was 3.5%.

Radiofrequency ablation (RFA) has been widely used for the treatment of various solid organ malignancies. Over the last decade, endosonographers have gradually shifted the application of RFA from porcine models to humans to treat a spectrum of diseases. RFA is performed in patients with pancreatic carcinoma who are not candidates for surgery. In this paper, we will discuss various indications for RFA, its procedural details and complications. At present, endoscopic ultrasound-guided RFA is gradually incorporated into the management of various diseases and opens a new avenue for disease treatment.

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Background: Biliary T-tubes were once considered an essential operative tool that mandated surgeon familiarity. Given advances in both interventional gastroenterology and radiology, coupled with minimal T-tube experience amongst graduating surgical residents, the contemporary role of Ttubes is unclear. The primary goal was to systematically evaluate the modern utility of T-tubes. The secondary goal was to describe potential T-tube technical pitfalls. Methods: A systematic review (Medline, PubMed, EMBASE, Web of Science, Cochrane) was completed (PRISMA methods) to evaluate the role of T-tubes. This was combined with a retrospective audit of technical complications as a direct result of T-tube management. Results: Among 194 citations, no randomized trials or prospective studies of reasonable methodologic quality were noted. The current literature is limited in its insight into the role of biliary T-tubes. Most descriptions occur within textbooks, dated retrospective audits and invited reviews. Ttube related complication themes include: (1) poor T-tube sizing, (2) poor T-tube preparation, (3) common bile duct injury during T-tube insertion, (4) early T-tube dislodgement and (5) sepsis from T-tube obstruction. Conclusion:The current role of T-tubes has been dramatically reduced secondary to advances in multidisciplinary techniques and lack of familiarity amongst graduating trainees.Complications in technique are not uncommon.

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