RESUMEN
To compare the outcome with and without aspiration of the amoebic liver abscess. Comparative study. This study was conducted at Medical Wards of Civil Hospital Karachi from August 2010 to September 2011. Study consisted of 100 patients and divided into two groups. Both the groups received medical therapy from day 1 which included Metronidazole injection 500mg i/v 8 hourly. Liver abscess was diagnosed on clinical features, ultrasound finding, aspiration with clinical study and serological tests for amoebiasis In Inclusion criteria; age greater than 12 years and less than 60 years and Evidence of liver abscess on abdominal ultrasound. In Exclusion criteria; a] Patients of less than 12 years and more than 60 years and pregnant woman. Mean age of ALA in Group A 36.98+ 3.25 years in both group with male female is ratio of 4:1. Anaemia was present in 76% cases, leukocytosis was found in 90% case. Among them 4[4.44%] cases had leukocyte count greater than 30,000/mm3 with absolute neutrophilia. 16[17.77%] patients had TLC in the range of 21,000-30,000/mm3. However, the majority of cases 70 [77.77%] had TLC in the range of 10,000-20,000/mm3 and only 10 patients had normal TLC. ESR was found in triple figure in 24% cases, whereas in 40% cases it was between 50 and 100 and in 36% patients found below 50mm/1st hour. Liver aspiration was done in 72 cases. The colour of aspirate was reddish brown in 60 cases [83.33%] and yellowish in 12 cases [16.66%]. Air bubbles were not demonstrated in any case. Trophozoites of Entamoeba histolytica were demonstrated in 5 cases [10%]. Serologic test for ALA i.e. indirect haem agglutination test was proved to be very specific with 100% showing high antiamoebic antibody titre. The mean abscess size 6.5 cm in Group A and 7.3 cm in group B. The mean abscess size and the impact of aspiration in terms of normalization in fever, TLC and improvement in LFTs. Percutaneus aspiration is a safe and effective treatment of amoebic liver abscess disease