ABSTRACT
BACKGROUND: amebic liver abscess is frequently seen in endemic regions, and has a poor prognosis when diagnosis and treatment are inappropriate. AIM: to evaluate and compare our own results; to propose a new classification and therapeutic algorithm. DESIGN: an observational and retrospective study. METHOD: medical records were reviewed for sex, age, signs and symptoms, images, laboratory tests, size, location, treatment, hospital stay, and morbidity-mortality. RESULTS: sixteen patients with amebic liver abscess had been treated -9 were males, mean age was 30.56 years, all abscesses were solitary, 14 were in the right hepatic lobe, average size was 63.25, and 10 were of the collected type according to N Gbesso s classification. Seven patients had a good response to medical treatment, 6 needed percutaneous drainage, and 3 required surgery. Morbidity was 12.5% and mortality 0%. Average hospital stay was 7.68 days. CONCLUSION: our results are similar to those in other published series. The addition of two new groups to N Gbesso s classification provides better therapeutic orientation. We believe that early percutaneous drainage for collected abscesses bigger than 5 cm may improve symptoms and shorten hospital stay.
Subject(s)
Liver Abscess, Amebic/therapy , Adolescent , Adult , Algorithms , Child , Child, Preschool , Humans , Middle Aged , Retrospective Studies , Time FactorsABSTRACT
Antecedentes: los abscesos amebianos hepáticos se presentanfrecuentemente en zonas endémicas, teniendo mal pronósticosi no son diagnosticados y tratados adecuadamente.Objetivo: evaluar nuestros resultados, ampliar la clasificaciónultrasonográfica utilizada y proponer un algoritmo terapéutico.Diseño: retrospectivo observacional.Método: revisión de los expedientes clínicos de los pacientesy valoración de los siguientes datos: sexo, edad, signo-sintomatología,métodos complementarios de imágenes y laboratorio, tamaño,localización, estancia hospitalaria y tratamiento.Resultados: fueron tratados 16 abscesos, 9 fueron hombres,la media etaria fue de 30,56 años, todos fueron únicos, 14 se localizaronen el lóbulo derecho, la media en medida fue de 63,25milímetros, 10 fueron del tipo coleccionado en la clasificación deNGbesso. Siete pacientes tuvieron buena respuesta con el tratamientomédico, en 6 se realizó drenaje percutáneo y en 3 cirugía.La morbilidad fue del 12,5% y la mortalidad del 0%. La estanciahospitalaria global tuvo una media de 7,68 días.Conclusión: nuestros resultados son similares a otras series,el agregado a la clasificación de NGbesso de abscesos intermediosy complicados o con signos de alarma mejora la orientaciónterapéutica, creemos que el drenaje precoz en abscesos coleccionadosde 5 o más cm mejora la sintomatología y disminuye la estanciahospitalaria
Background: amebic liver abscess is frequently seen in endemicregions, and has a poor prognosis when diagnosis andtreatment are inappropriate.Aim: to evaluate and compare our own results; to propose anew classification and therapeutic algorithm.Design: an observational and retrospective study.Method: medical records were reviewed for sex, age, signsand symptoms, images, laboratory tests, size, location, treatment,hospital stay, and morbidity-mortality.Results: sixteen patients with amebic liver abscess had beentreated 9 were males, mean age was 30.56 years, all abscesseswere solitary, 14 were in the right hepatic lobe, average size was63.25, and 10 were of the collected type according to NGbessosclassification. Seven patients had a good response to medicaltreatment, 6 needed percutaneous drainage, and 3 requiredsurgery. Morbidity was 12.5% and mortality 0%. Average hospitalstay was 7.68 days.Conclusion: our results are similar to those in other publishedseries. The addition of two new groups to NGbessos classificationprovides better therapeutic orientation. We believe that earlypercutaneous drainage for collected abscesses bigger than 5 cmmay improve symptoms and shorten hospital stay
