Amebic liver abscess: Spare the knife but save the child

Moazam, Farhat; Nazir, Zafar

doi:10.1016/s0022-3468(98)90376-1

Cited by 38 publications

(27 citation statements)

References 13 publications

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“…In majority of the cases, increased alkaline phosphatase and low albumin has been reported while some patients may have raised bilirubin and raised SGOT and SGPT [5]. Kaplan [7] reported normal liver function tests in pyogenic liver abscess, while Moazam and Nazir [11] reported raised bilirubin in patients with amoebic liver abscess.…”

Section: Discussionmentioning

confidence: 99%

“…All uncomplicated amoebic liver abscesses can be managed medically and do not require aspiration. However, when no clinical response occurs within 48 h of treatment, or superinfection is suspected or abscess is 6 cm or more in size, the patient is in septicemia or there is a risk of rupture, percutaneous aspiration is considered [8,11]. Surgical drainage is necessary when abscess has ruptured.…”

Section: Discussionmentioning

confidence: 99%

“…Large multiple abscesses and a solitary abscess more than 6 cm need percutaneous or open drainage. Those with multiloculated abscess, ongoing sepsis despite antibiotics and percutaneous drainage or those with thick pus need open drainage [10,11].…”

Section: Introductionmentioning

confidence: 99%

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Percutaneous aspiration versus open drainage of liver abscess in children

et al. 2006

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Liver abscess, though a very grave problem, is rarely seen in infancy and childhood. Affected children are usually immunocompromised and are of poor socioeconomic status. Although liver abscess due to wandering ascarids is rare outside, it is common complication among children of Kashmir. Usual site of abscess is the right lobe of the liver and USG and CT of the abdomen are the main tools of diagnosis. The study was conducted over a period of 10 years from January 1991 to December 2000 and total of 129 cases were studied in the age group of 0-14 years. Diagnosis was made by a detailed clinical examination together with USG and CT of the abdomen. Out of 129 cases, 49 were treated with antibiotics alone, 55 cases were taken for open drainage, and 27 cases were taken for percutaneous aspiration under USG guidance. Percutaneous aspiration failed in five patients who were later taken for open drainage. Open method was found still to be the best modality of management, although percutaneous aspiration is safe and effective but needs lot of expertise.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Percutaneous aspiration versus open drainage of liver abscess in children

et al. 2006

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“…Surgical intervention has been recommended by many authors for complicated and ruptured ALA and amoebic abscess rupturing into the gastrointestinal tract was considered as surgical entity [9]. But from our recent experience, we strongly agree with Moazam and Nazir [12] that parenteral metronidazole along with judiciously planned percutaneous drainage can prevent the need for extensive surgical intervention even in large complicated and ruptured ALA [9]. Surgical intervention may be needed if there are simultaneously multiple fistulae or one fails to diagnose hepatogastric fistula preoperatively.…”

Section: Discussionmentioning

confidence: 79%

“…Both medical and/or surgical management of these lesions exist. The efficacy of metronidazole in treatment of ALA is well established but the role of surgical intervention remains controversial [12]. Surgical intervention has been recommended by many authors for complicated and ruptured ALA and amoebic abscess rupturing into the gastrointestinal tract was considered as surgical entity [9].…”

Section: Discussionmentioning

confidence: 99%