Intraperitoneal rupture of amoebic liver abscess

Abstract

A retrospective analysis of 23 cases of amoebic liver abscess with intraperitoneal rupture is presented. Group I consisted of 16 patients with clinical features of generalized peritonitis. Eight of these patients were treated surgically, and four died. Group II consisted of seven patients with features of localized peritonitis and all were treated conservatively. In all cases the diagnosis of liver abscess was established by liver scan or ultrasound examination; peritonitis was established either at operation or, in the conservatively managed group, by aspiration of pus from the peritoneal cavity. Amoebiasis was diagnosed by serology. Eight group I and all group II patients were managed conservatively by aspiration of the liver abscess, antibiotics and amoebicides. There were no deaths in this group. It is suggested that, if the diagnosis can be made early, conservative treatment offers the best chance of cure for patients of amoebic liver abscess with intraperitoneal rupture.

Audit of patients with ruptured amoebic liver abscess and outcome of surgical versus non-surgical treatment

“…It is more common in males, similar to Sarda et al, where in the male is to female ratio was 19:45. 5 Amoebic liver abscess occurs in all age groups and common mode of transmission is by contaminated food and water. It is a disease commonly seen in the lower class and lower middle class of the society with poor cooking habits.…”

Hepatic amebiasis: a reminder of the complications

“…Peritonitis occurs in 2-7% of ALA, and manifests as either acute peritonitis from sudden abscess perforation, subacute localized peritonitis, or chronic peritonitis. Acute peritonitis is the most common and is associated with severe systemic illness (9, 10). Though intestinal perforation occurs with amebic peritonitis, gastric rupture, as in our patient, is rarely reported (5).…”

“…Management of complications of ALA, with its high mortality, is a source of constant worry for the clinician (1) (7, 8, 10, 13-17). Though reports describing series of cases exist, exact management strategies have not been extensively explored.…”

Laparoscopic Surgery for Intra-abdominal Ruptured Liver Abscess: A study of 32 cases

“…There are various complications associated with hepatic abscesses, of which, rupture of the abscess is the most common [3][4][5]. Intraperitoneal rupture of liver abscess is a rare but potentially fatal disease, often involving the elderly, who are commonly of poor surgical risk with background of significant medical illness [6,7]. Accurate preoperative diagnosis is difficult and often necessitates exploratory laparotomy for peritonitis [8].…”