Amoebic liver abscess; needle aspiration after 96 hours of medical treatment

ABSTRACT

Amoebic Liver Abscess [ALA] is a serious problem in Pakistan Its management includes antimicrobial drugs, needle aspiration and surgical drainage. To determine if amoebic liver abscess can be treated conservatively or requires needle aspiration as well in selected cases. A prospective hospital based study. Nishtar Hospital Multan. 18 months. Thirty six consecutive adult patients with a right lobe liver abscess were included. All patients received metronidazole 800mg orally for 10-14 days and were clinically observed. Patients who did not show any clinical improvement in 96 hours had an ultrasound guided needle aspiration performed. Patients having an ALA less than 10cm in size respond to medical treatment. If patients continue to have toxic symptoms, needle aspiration should be performed. Most patients having ALA of >10cm will end up having a needle aspiration but should be given a trial of medical management