Amebic liver abscess with jaundice

Sarda, A. K.; Kannan, Ravi; Gupta, Anju; Mahajan, Vandana; Jain, Pashupati Kumar; Prasad, Sumit

doi:10.1007/s005950050127

Cited by 12 publications

(5 citation statements)

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“…Yoo et al [28] in their study compared data of patients between 1970s and 1980s and reported a fall in incidence of jaundice from 25% to 7% during this period. Pathogenic processes proposed which can lead to jaundice are sepsis, alcoholic liver disease, hepatocellular dysfunction, associated hepatitis in the adjoining areas, intrahepatic biliary obstruction by the expanding abscess, and biliovascular fistula resulting from hepatic necrosis leading to damage of bile ducts and hepatic veins [29, 30]. However, no biliovascular fistula was detected by ultrasound doppler in any of our case.…”

Section: Discussionmentioning

confidence: 74%

Clinical, Laboratory, and Management Profile in Patients of Liver Abscess from Northern India

Ghosh

Sharma

Gadpayle

et al. 2014

Journal of Tropical Medicine

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Objective. To describe the clinical profile, microbiological aetiologies, and management outcomes in patients with liver abscess. Methods. A cross-sectional study was conducted from May, 2011, to April, 2013, on 200 consecutive liver abscess patients at PGIMER and Dr. RML Hospital, New Delhi. History, examination, and laboratory investigations were recorded. Ultrasound guided aspiration was done and samples were investigated. Chi-square test and multivariate regression analysis were performed to test association. Results. The mean age of patients was 41.13 years. Majority of them were from lower socioeconomic class (67.5%) and alcoholic (72%). The abscesses were predominantly in right lobe (71%) and solitary (65%). Etiology of abscess was 69% amoebic, 18% pyogenic, 7.5% tubercular, 4% mixed, and 1.5% fungal. Percutaneous needle aspiration was done in 79%, pigtail drainage in 17%, and surgical intervention for rupture in 4% patients. Mortality was 2.5%, all reported in surgical group. Solitary abscesses were amoebic and tubercular whereas multiple abscesses were pyogenic (P = 0.001). Right lobe was predominantly involved in amoebic and pyogenic abscesses while in tubercular abscesses left lobe involvement was predominant (P = 0.001). Conclusions. The commonest presentation was young male, alcoholic of low socioeconomic class having right lobe solitary amoebic liver abscess. Appropriate use of minimally invasive drainage techniques reduces mortality.

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Section: Discussionmentioning

confidence: 74%

Clinical, Laboratory, and Management Profile in Patients of Liver Abscess from Northern India

Ghosh

Sharma

Gadpayle

et al. 2014

Journal of Tropical Medicine

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“…A large ALA located in the caudate lobe can cause compression of the vena cava, resulting in pedal edema. Obstructive jaundice may occur from an ALA close to the porta hepatis[ 47 ]. Jaundice in ALA can also result from a biliovascular fistula created due to the simultaneous injury to the bile ducts and hepatic veins.…”

Section: Complications Of Alamentioning

confidence: 99%

Amebic liver abscess: An update

Kumar,

Patel,

Priyadarshi

et al. 2024

World J Hepatol

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Amebic liver abscess (ALA) is still a common problem in the tropical world, where it affects over three-quarters of patients with liver abscess. It is caused by an anaerobic protozoan Entamoeba hystolytica , which primarily colonises the cecum. It is a non-suppurative infection of the liver consisting primarily of dead hepatocytes and cellular debris. People of the male gender, during their reproductive years, are most prone to ALA, and this appears to be due to a poorly mounted immune response linked to serum testosterone levels. ALA is more common in the right lobe of the liver, is strongly associated with alcohol consumption, and can heal without the need for drainage. While majority of ALA patients have an uncomplicated course, a number of complications have been described, including rupture into abdomino-thoracic structures, biliary fistula, vascular thrombosis, bilio-vascular compression, and secondary bacterial infection. Based on clinico-radiological findings, a classification system for ALA has emerged recently, which can assist clinicians in making treatment decisions. Recent research has revealed the role of venous thrombosis-related ischemia in the severity of ALA. Recent years have seen the development and refinement of newer molecular diagnostic techniques that can greatly aid in overcoming the diagnostic challenge in endemic area where serology-based tests have limited accuracy. Metronidazole has been the drug of choice for ALA patients for many years. However, concerns over the resistance and adverse effects necessitate the creation of new, safe, and potent antiamebic medications. Although the indication of the drainage of uncomplicated ALA has become more clear, high-quality randomised trials are still necessary for robust conclusions. Percutaneous drainage appears to be a viable option for patients with ruptured ALA and diffuse peritonitis, for whom surgery represents a significant risk of mortality.With regard to all of the aforementioned issues, this article intends to present an updated review of ALA.

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“…8 Several studies have also found an association between hyperbilirubinemia and Liver abscesses, with studies finding incidence of jaundice in patients with amoebic liver abscess is a frequent occurrence, the incidence varying between 6% and 29%. [9][10][11][12][13] More recent studies done by Lin et al, has suggested a correlation between chronic proton pump inhibitor use and development of pyogenic liver abscess. 14 However the advancements in antibiotic therapy and advancements in radiology have caused a gradual shift in the epidemiology of the disease.…”

Section: Introductionmentioning

confidence: 99%

Our experiences with liver abscesses in hospitals attached to Bangalore Medical College and Research Institute, India

2018

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Background: Liver abscess is a common problem in India and is associated with high morbidity and mortality. Broadly they can be divided into two types- Pyogenic and Amoebic. Amoebic in particular has a very high burden on society in India, believed to be secondary to poor sanitation and hygiene in the population.Methods: We performed a prospective, descriptive case series assessing demographic characteristics, presentation patterns, etiological factors, microbiological etiology, and management for patients treated for liver abscess at our centres between 2016 and 2018. 70 patients were identified and diagnosed on the basis of ultrasound and gram staining and culture of the pus aspirate.Results: Amoebic liver abscess was in majority (75%), with males being more affected than females (90%). Alcoholic and diabetic males between 30 and 50 years of age were most affected. Most presented with abdominal pain (96%). 53% needed Pigtail catheter drainage. Average duration of stay was 8 days, and 72% of the total patients showed relief of symptoms within 3 days.Conclusions: Most cases were found to be due to amoebic etiology rather than pyogenic. Both amoebic and pyogenic abscesses are noted to be more common in young men between the ages of 20 - 50, with a higher incidence noted among the alcoholic and diabetic patients. Most patients present with Upper abdominal pain and ultrasound is a useful tool in diagnosing the condition and providing valuable information about the site and volume of the abscess. Majority of patients needed Ultrasound guided drainage of the abscess. Average hospital stay was 8 days.

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Amebic liver abscess with jaundice

Cited by 12 publications

References 5 publications

Clinical, Laboratory, and Management Profile in Patients of Liver Abscess from Northern India

Clinical, Laboratory, and Management Profile in Patients of Liver Abscess from Northern India

Amebic liver abscess: An update

Our experiences with liver abscesses in hospitals attached to Bangalore Medical College and Research Institute, India

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