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- Title
Amebic Liver Abscess: A Study of 11 Cases Compared with a Series of 38 Patients with Pyogenic Liver Abscess.
- Authors
Greenstein, Adrian J.; Barth, Jay; Dicker, Adam; Bottone, Edward J.; Aufses Jr., Arthur H.
- Abstract
Amebic liver abscess is an uncommon disease in the northern states of North America with 11 cases seen among approximately 500,000 Mount Sinai Hospital admissions over a 16-year period. Five of 11 cases originated in, or had recently visited South America. In three of these, and two patients with concomitant intestinal amebiasis, the diagnosis was suspected on admission. Diagnosis after admission was rapid, mean 5 days, compared with a mean of 13 days in pyogenic liver abscess. There was a higher incidence of male patients, nine males versus two females which was greater than the excess found in our pyogenic abscesses, 22 <em>versus</em> 16. Multiplicity was less common than in pyogenic abscess, 27 versus 50%, respectively. All three patients with multiple abscesses survived with surgical drainage and antibiotic therapy despite numerous complicating factors, including secondary bacterial infection. One patient resolved with drug treatment only; all others were treated with drugs and concomitant drainage; surgical drainage in earlier cases, and percutaneous drainage more recently. There was a single postoperative death. Drug treatment is the first therapeutic modality, and if recovery is delayed more than 2 days percutaneous aspiration should he carried out. This was successful in four cases. Surgery should seldom be required with present methods of accurately localizing amebic liver abscess, but is essential for ruptured abscess with peritonitis, and liver abscess with associated intestinal problems such as toxic megacolon, colonic perforation, or fulminating colitis. There has been a significant reduction in mortality of amebic liver abscess over the past 50 years and particularly within the past decade. This reflects early diagnosis, and accurate localization as a result of nuclear scanning, and computerized tomography; precise and complete percutaneous drainage when necessary; and improved drug therapy.
- Subjects
AMEBIC liver abscess; LIVER abscesses; AMEBIASIS; ABSCESSES; BACTERIAL diseases; DIAGNOSIS
- Publication
American Journal of Gastroenterology (Springer Nature), 1985, Vol 80, Issue 6, p472
- ISSN
0002-9270
- Publication type
Article