MANAGEMENT OF RUPTURED AMOEBIC LIVER ABSCESS: 22-YEARS EXPERIENCE

Authors

  • AS Memon
  • FG Siddiqui
  • HA Memon
  • SA Ali

Abstract

Background: Amoebiasis affects approximately 10% of the population all over the world. Amoebicliver abscess (ALA) is the commonest complication of amoebiasis affecting 3–9% victims. It is anancient disease as Hippocrates notified large hepatic abscesses likely to be amoebic abscesses.Objective of this study was to see the efficacy of conservative treatment in the management of rupturedamoebic liver abscess. Methods: Record of 1,083 patients of amoebic liver abscess, who were treatedand managed at Liaquat University Hospital between January 1986 and December 2007, was reviewedretrospectively. Amongst these, 36 (3.32%) patients, found to have intra-peritoneal rupture of the liverabscess were included in this study. The record of these patients was reviewed. The patients weredivided into group A and B depending upon the mode of treatment employed. Group A included 16(44.44%) patients in whom exploratory laparotomy was performed while group B included 20(55.55%) patients who were treated conservatively. Results: Group A consisted of 16 (44.4%) patientswho underwent laparotomy for acute peritonitis due to non-availability of ultrasound in the initialperiod of the study. In group B, all twenty patients were treated conservatively after a diagnosis ofruptured amoebic liver abscess made by ultrasound guided percutaneous aspiration of pus. Thesepatients were treated with ultrasound guided aspiration of pus with placement of peritoneal drain underlocal anaesthesia. Six patients in group A died compared to one patient in group B. the overall mortalityof ruptured amoebic liver abscess was 19.4%. It was higher in patients treated surgically (37.5%)compared to patients who were treated conservatively (5%). Conclusion: Conservative treatment is aneffective modality of treatment for ruptured liver abscess with minimum mortality and mortality ifdiagnosis is made early.Keywords: Amoebic liver abscess, intra-peritoneal rupture, exploratory laparotomy, conservativetreatment, mortality and morbidity

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Published

2010-06-01

Issue

Vol. 22 No. 2 (2010): JOURNAL OF AYUB MEDICAL COLLEGE, ABBOTTABAD

Section

ORIGINAL ARTICLE

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