Amoebic Liver Abscess: Analysis of Two Hundred cases: Presentation and Management

Abstract

Two hundred cases of the amoebic liver abscess were seen during period of 6 years (July 1992 to January 1998) at the Surgical Department of Nishtar Hospital, Multan and Surgical Departments of B.V. Hospital, Bahawalpur. It was more commonly seen in 3rd and 4th decade of the life with a male predominance and 80% of the patients belonged to the lower socio economic strata. Right lobe was the site of the amoebic abscess in 70% cases, 20%had left lobe abscess and in 10% multiple abscesses were present. The presenting features were anaemia, fever, weight loss, pain right hypochondrium, tenderness was present in 80% cases and enlargement of the liver in 75% cases. Abscess size varied from 4 to 15cm. All the large abscesses were aspirated in multiple sittings and laparotomy/open drainage was done only if above method failed or patient developed rupture of liver abscess. It is concluded that small abscess can be treated by medicamentous therapy moderate to large size abscesses by needle aspiration along with metronidazole and ruptured abscess by open drainage.