JOURNAL OF EVIDENCE BASED MEDICINE AND HEALTHCARE

Table of Contents

2018 Month : August Volume : 5 Issue : 32 Page : 2389-2393

CLINICAL ANALYSIS OF AMOEBIC LIVER ABSCESS

Aravind Ramachandra Mirajkar1, Kalavathi G. P2

Dr. Kalavathi G. P,
Assistant Professor,
Department of General Medicine,
Karwar Institute of Medical Sciences,
Karwar- 581301, Karnataka.
E-mail: kalavathigp@gmail.com
DOI: 10.18410/jebmh/2018/493

ABSTRACT
BACKGROUND
Hepatic Amoebiasis is the infection of the hepatic tissue by the trophozoite form of Entamoeba histolytica from the intestine. Hepatic amoebiasis or liver abscess is commonest complication of amoebiasis.
The aim of the study is to know the clinical profile of amoebic liver abscess using a non-invasive diagnostic procedure like screening chest X-ray with special reference to abdominal ultrasound to confirm amoebic liver abscess. Clinical course of disease admitted to hospital and response to both medical and surgical line of treatment were studied.

MATERIALS AND METHODS
Thirty-five patients referred to general medicine department of Karwar Institute of Medical Sciences were screened and selected for this study. Inclusion criteria for study are patients having right hypochondriac pain and palpable tender liver with intercostal tenderness &/or patients having fever, chills, rigor with palpable tender liver &/or patients having cough, breathlessness, right sided chest pain and palpable tender liver &/or patients having loose motion, pain abdomen and palpable tender liver. All the patients who fulfilled inclusion criteria were subjected to blood test, X-ray and abdominal ultrasonography.

RESULTS
Fourteen patients gave history of loose motion associated with blood and mucus, blood or mucus. Pain abdomen, fever and right sided chest pain were the most common symptoms in these patients. Fever and anaemia were the most general physical examination findings. On systemic examination, intercoastal tenderness and tender hepatomegaly were seen in nearly all the patients. Anaemia was seen in 71.4%, polymorphonuclear leucocytosis in 65.70% and raised ESR in 77.01% of patients. All the patients had elevated diaphragm, which had restricted movement on X-ray. On abdominal ultrasonography, abscess was observed in right lobe of liver in majority of cases. In the present study, two patients expired before any medical intervention could be given.

CONCLUSION
Pain abdomen and right sided chest pain associated with fever is the presenting complaint. Intercostal tenderness with tender hepatomegaly is seen in almost all cases. Clubbing, jaundice, pedal edema and tachycardia are some findings in general examination. Anaemia, polymorphonuclear leukocytosis and raised ESR are seen in 2/3 of the patients. Solitary right lobe abscess was seen in 91.4% of cases. Raised diaphragm with restriction of movement seen in all patients.

KEYWORDS
Amoebic Liver Abscess, Clinical Analysis, Abdominal Ultrasonography, X-Ray.