Clinical profile of amoebic liver abscess patients admitted in a tertiary care hospital

Abstract

Amoebic liver abscess is an important cause of space occupying lesions of the liver, especially in tropical and sub tropical regions. It is the most frequent complication of invasive amebiasis. It may be found in all age groups but relatively rare in children. The signs and symptoms vary according to the severity of illness. The present study was done to evaluate the clinical profile of patients with amoebic liver abscess for age, gender, clinical features, site of abscess, number of abscess, treatment modality by intravenous metronidazole along with percutaneous needle aspiration and prognosis. A prospective study of 86 admitted patients of amoebic liver abscess were included in this study which was carried out in the medicine department of Khulna Medical College Hospital over a period of 2 years from July 2010 to June 2012. Mean age of patients was 45 years. Male female ratio was 7:1. The mean duration of fever was 17.9 days and the mean duration of pain was 14.1 days. The duration of fever for more than 2 weeks was seen in 38 cases. Regarding clinical features, the major symptoms of fever, pain abdomen and dysentery were seen in 81, 78 and 10 cases respectively. The major signs as determined by clinical and radio imaging studies were hepatomegaly in 76, right lobe abscess in 60, left lobe abscess in 12, multiple abscesses in both lobes in 18, ascites in 5 and right sided pleural effusion in 12 cases respectively. All the cases underwent percutaneous needle aspiration. 5 cases died out of 86 patients.Bang Med J (Khulna) 2015; 48 : 20-23

Safety and efficacy of ultrasound guided percutaneous needle aspiration of liver abscess

“…6 In our study, 79% of the abscesses were located in the right lobe of liver, similar to previous studies. 6,9,10 and 78% of our patients had solitary abscesses, similar to a previous report. 6 We encountered multiple liver abscesses in 22% of the patients, similar to the 18-25% incidence of multiple liver abscesses.…”

“…6,7 Similarly our study did not correlate with some other studies. 8,9 In our study we found male to female ratio 8:1 which was similar to others. 6,9 Most of the patient are economically poor and lives in rural area.…”

“…8,9 In our study we found male to female ratio 8:1 which was similar to others. 6,9 Most of the patient are economically poor and lives in rural area. Male predominance may be attributed to the lifestyle with men going out to work and consuming contaminated water and unhygienic food while the women are largely confined to their homes.…”

“…6 One study showed 5 patients died out of 86 patient. 9 We required single aspiration in 30%, second aspiration in 38% and third aspiration in 32%. Average aspiration per patient was 2.02.…”

“…6 We encountered multiple liver abscesses in 22% of the patients, similar to the 18-25% incidence of multiple liver abscesses. 9,11 Still many centers are not involved in the percutancous drainage of liver abscess possibly due to unavailability of suitable percutaneous drainage sets, unavailability of USG machine at tretment site and absence of experienced hand. Previous studies have seen the use of Foley's catheter as drainage tubes.…”