A patient with 8 cm x 8 cm abscess in right lobe of liver was treated -with aspiration multiple times (3 times) and with systemic amebicide. Now cavity is remaining in right lobe of liver but there is nothing in the cavity. Seven days course of luminal amebicides is given. How will you follow up?
Ans. b. USG weekly for 1 month followed by monthly USG till 1 year In uncomplicated cases of amebic liver abscess, follow-up is done with ultrasound. Role of ultrasound in the diagnosis and treatment follow-up of amoebic liver abscess, by K. Shamsi, A. De Schepper, F. Deckers, E. de Bergeyck, J. Van den End "Serological and clinical data in combination with these nonspecific sonographic features are sufficient for the management of ALA, obting the need for expensive and invasive techniques in majority of the cases."- http://link. springer.com/aicle/10.100r/o2FBF00221420?Ll=true Sabiston says "The average time to radiologic resolution is 3 to 9 months and can take as long as years in some patients. Studies have shown that more than 90% of the visible lesions disappear radiologically, but a small percentage of patients are left with a clinically irrelevant residual lesion."
Stool examination only
USG weekly for 1 month followed by monthly USG till 1 year
USG weekly for 3 months followed by CT scan at 3 months.
USG or CT scan monthly and stool examination weekly