Fatal amoebic liver abscess: An autopsy study

Abstract

An autopsy study of 20 cases is presented. The mean age was 32 years (range: 14-45). Four cases (20%) presented with jaundice. Another four (20%) had continuous fever with abdominal pain. Six had loose motions with blood and mucus in the stools. The mean duration of illness was 7.2 days. All cases were thin and emaciated. Liver was grossly enlarged (mean weight: 2680 g). The abscess was single in all cases except one. The right lobe was involved in 15 cases, the left in four and both in one. The average size of abscess was 13 cm. The abscess had ruptured in the abdomen in 3 patients, for which laparotomy was performed. Pulmonary involvement was seen in 3 cases. Colon showed ulceration in half the patients. In 2 cases perforation was also present. No cerebral involvement was present. A number of interesting features emerged from this study. Although amoebic liver abscess is a common disease, its diagnosis can be missed due to unusual presentation. In the present study, diagnosis of viral hepatitis, carcinoma lung, bacillary dysentery and enteric fever with perforation were made, which probably contributed materially to fatal outcome.

The Modern Autopsy: What to Do if Infection Is Suspected

“…Gastrointestinal complaints are frequent nonspecific symptoms that accompany a variety of syndromes. When the gastrointestinal tract is the primary site of disease, those conditions most likely to produce death include bacillary dysentery, enteric fever, and amebic colitis/hepatic abscess (45). Shigella dysenteriae is the most virulent Shigella, producing classic dysentery that may be complicated by colonic ulceration, perforation, and peritonitis.…”