1995. A Study of Amoebic Liver Abscesses from Mumbai, India


 
 
 Microbial contamination of the liver parenchyma leading to liver abscess can occur via the bile ducts or vessels or directly, by contiguity. In India, amoebiasis is endemic and amoebic liver abscess (ALA) is the most common extraintestinal site of involvement. The epidemiology and characteristics of ALA have changed and the distinguishing features between pyogenic and amoebic liver abscess are unclear.
 
 
 
 32 consecutive patients presenting with liver abscess were included over a period of 18 months. Their demographic profile, comorbidities, characteristics of the abscesses on imaging (number, size, liquifaction, lobe involved, etc), complications, treatment given (both medical and interventional) were recorded. The abscess size was monitored by periodic sonography, both for liquification and response to therapy.
 
 
 
 
 A male preponderance was observed. 50 abscesses were noted in the 32 patients. 29 patients (90.63%) had ALA, 2 pyogenic (6.25%) and 1 cholangitic (3.125%). Fever and right hypochondrial pain were common complaints. Chronic diarrhoea was noted in only 4 (12.5%) patients. 92% were in the right lobe. Majority were unliquified / partially liquified at presentation. All underwent percutaneous drainage. 11 (34.375%) had rupture, with majority (25%) being in the perihepatic space. This local complication was associated with large and/or multiple abscesses. All ALA were treated with metronidazole for 3-4 weeks and a luminal amoebicide, with a good response. Only 2 patients expired, due to their comorbidities.
 
 
 
 The traditional belief that amoebiasis causes solitary abscess and bacteria cause multiple abscesses does not hold true anymore. Leucocytosis is seen with ALA too. Alcoholism and underlying comorbidities are not prerequisites for developing liver abscess. A combination of medical and interventional therapy produces good results, even in multiple abscesses.
 
 
 
 All Authors: No reported disclosures.
