Sanjay Gupta1, Amit Verma2, Prashant Sarda3
BACKGROUND
Amoebic liver abscess is a common clinical problem, encountered in clinical
practice. There is sparse literature about socio epidemiological and current clinical
trends and treatment outcomes. The current article describes the outcomes in a
prospectively studied cohort of patients from a tertiary referral centre from
Himalayan foothills and Sub Himalayan Gangetic plains of North India.
METHODS
101 prospectively enrolled, serial patients, fulfilling the criteria for amoebic liver
abscesses were included in the study to evaluate the socio epidemiological, clinical
variables and abscess outcomes. The intervention done for abscesses requiring
drainage (one-time aspiration vs. indwelling catheter drainage) was mainly
dependent upon the content of liquefied pus in the abscess cavity rather than
absolute size of the abscess. The colour of the aspirated pus and final outcomes
of patients were recorded.
RESULTS
There were 9.75 cases of lever abscess per 10,000 hospital admissions, similar to
the trends reported from other endemic regions. While the socio epidemiological
and clinical variables remained unchanged for the last 60 years, the clinical
outcome has dramatically improved. The average volume of the abscess noted in
the study appeared smaller than the average volume of the abscess noted in
earlier studies, possibly suggesting early diagnosis. About 1 / 3rd abscess were
noted to be complicated, either with symptomatic pleural effusion (29) or rupture
(5 / 101) and correlated significantly with socio economic status and history of
alcoholism. There was no statistical difference in the average volume of the
abscess cavity, in patients managed either with one-time aspiration or indwelling
catheter drainage. All patients had excellent outcome. None of the patients
required surgery and there was no mortality.
CONCLUSIONS
While there is no change in the epidemiology of amoebic liver abscess, there is a
marked change in the outcome, and amoebic abscess is a potentially curable
disease.
