Prospective Observational Study to Review the Contemporary Management of Amoebic Liver Abscess

ABSTRACT

Introduction: Amoebic liver abscess is an inflammatory space-occupying lesion of the liver caused by Entamoeba histolytica.Trophozoites after lodging in sufficient numbers in venules lead to thrombosis and infarction and microabscesses formationand thence amoebic abscess. Fever and pain right upper quadrant are very common.Aims and Objectives: The aim of the study was to review the contemporary management of amoebic liver abscess.Materials and Methods: This hospital based observational study for 100 patients was performed in the Surgery Departmentin SGT Medical College, Budhera, Gurugram, Haryana. A detailed history and focussed clinical examination and requiredinvestigations were done. Patients were divided into three categories according to sizes of abscesses, <5 cm, 5–8 cm, and>8 cm. In Category I, patients were treated with metronidazole 40 mg/kg body weight in three divided doses. If toxemia wasthere, then metronidazole 100 ml, IV 8 hourly was given for 3–4 days and switched onto oral metronidazole. In CategoryII, if a trial of conservative treatment for 3 days did not relieve the symptoms, and in Category III, ultrasound-guided pigtailcatheterization was done.Results: In our study, maximum patients were between 21 and 60 years of age. Malefemale ratio was 4.551. Patients presentedwith fever, pain right hypochondrium, and hepatomegaly. Liver enzymes were elevated. Total lymphocyte counts were raisedand serum albumin was decreased in some patients.Conclusion: Due to our concrete planning and meticulous care at every step, there was lack of infection at the port site ordeep-seated, and there has been no failure of resolution, no hemorrhage, recurrence, pleural complications, and fever andthere has been no death in our series.