Treatment Of Amebic Liver Abscess Research Articles

ХИРУРГИЧЕСКОЕ ЛЕЧЕНИЕ ВНЕКИШЕЧНОГО АМЕБИАЗА С РАЗВИТИЕМ АБСЦЕССА ПРАВОЙ ДОЛИ ПЕЧЕНИ

Background. Due to the polymorphism, low prevalence in RB and in turn the difficulty of diagnosis, the treatment of extraintestinal amoebiasis is an important issue of surgery. Objective. To demonstrate the results of surgical treatment of a patient with amebic liver abscess. Material and methods. The article presents its own clinical observation of the surgical treatment of amebic liver abscess. The patient underwent drainage of the right liver lobe abscess under the laparoscopic control according to the method developed in the clinic. Results. The patient was discharged in satisfactory condition for further out-patient follow-up by the surgeon and infectious disease doctor at the place of residence. There were no repeated appeals and admissions. Conclusions. Clinical observation indicates the need for combined treatment of amoebic liver abscesses using external drainage in combination with conservative therapy, including the use of broad-spectrum antibiotics and metronidazole.

Percutaneous needle aspiration in uncomplicated amebic liver abscess: a randomized trial

Amoebic liver abscess develops in less than 1% of patients with amoebaisis and metronidazole is the drug of choice for the treatment of amebic liver abscess. Abscesses of less than 5 cm can be treated with metronidazole alone. However, abscesses of more than 10 cm must undergo ultrasound guided percutaneous needle aspiration along with metronidazole. The role of percutaneous needle aspiration in abscesses of 5 to 10 cm is not clear. Fifty-seven patients with a solitary, right lobe, uncomplicated amoebic liver abscess of 5-10 cm were randomized to receive either metronidazole alone (control group; n = 29) or ultrasound guided percutaneous needle aspiration along with metronidazole (intervention group; n = 28). Although the resolution of pain and fever occurred earlier in the intervention group (27 h and 17 h, respectively) than the control group (48 h and 30 h, respectively), the difference was not statistically significant (P = 0.16 and 0.48, respectively). There were no deaths during the study period and treatment failure, complications (rupture of abscess), days to normalization of leukocytosis and duration of hospitalization were similar in both groups. Ultrasound guided percutaneous needle aspiration along with metronidazole was no better than metronidazole alone in the management of uncomplicated, solitary, right lobe amoebic liver abscess of 5 to 10 cm.

AMEBIC LIVER ABSCESS

Amebiasis is a widespread parasitic disease caused by Entamoeba histolytica. This protozoan organism is the third leading parasitic cause of death in the developing world and is an important health risk to travelers in endemic areas. Amebiasis most commonly results in asymptomatic colonization of the gastrointestinal tract, but some patients may develop intestinal invasive disease or extraintestinal disease-amebic liver abscess being the most common extraintestinal manifestation. This article reviews epidemiologic features, pathophysiology, clinical features, diagnostic tests, imaging studies, treatment of amebic liver abscess, and prevention measures.

Amebic liver abscess: Spare the knife but save the child

Background/Purpose: Amebic liver abscess (ALA), the most common extraintestinal manifestation of infection with Entameba histolytica, carries significant morbidity and mortality in the pediatric age group. The efficacy of metronidazole in the treatment of ALA is well established, but the role of surgical intervention remains controversial. Many investigators still advocate aggressive surgical therapy for complicated and ruptured ALA. Reports regarding management of ALA in children are sparse and deal with small numbers of patients. The objective of this study was to assess the effectiveness of parenteral metronidazole combined with judicious aspiration of ALA in obviating the need for surgical intervention. Methods: The medical records of all children admitted with the diagnosis of ALA between 1986 and 1997 to the Aga Khan University Hospital were reviewed retrospectively. The diagnosis of ALA was confirmed in 48 patients by an ultrasound scan together with elevated indirect hemagglutination (IHA) titres (>250). Ages ranged from 3 weeks to 14.5 years. Results: Thirty-seven (75%) children were below the fifth percentile for height and weight, and 45 (93.7%) presented with a hemoglobin level of less than 10.0 g/dL. Comorbid factors included pulmonary tuberculosis (n = 2, chicken pox (n = 1), tetralogy of Fallot (n = 1), and thalassemia major (n = 2). There was a mean delay of 13 days before presentation to the hospital. All patients were treated with parenteral metronidazole and broad-spectrum antibiotics. The latter were discontinued on confirmation of the diagnosis. The duration of treatment with metronidazole ranged from 2 to 5 weeks. Percutaneous aspiration of the ALA was performed under ultrasound guidance using sedation in 28 patients for one or more of the following indications; ALA greater than 7.0 cms (n = 20), left lobe involvement (n = 8), and no response after 48 hours of medical therapy (n = 6). Nine patients required more than one aspiration. One patient with peritoneal rupture of the ALA additionally underwent percutaneous aspiration of the peritoneal cavity under ultrasound guidance. One patient required insertion of a chest tube after rupture of the ALA into the right pleural cavity, and another underwent urgent bronchoscopy after rupture of the abscess into the tracheobronchial tree. The hepatobronchial fistula closed spontaneously with medical therapy. No patient required open surgical drainage, and all recovered without relapse. The mean duration of hospitalization was 12 days. Conclusion: Our experience suggests that parenteral metronidazole combined with timely aspiration of the abscess can obviate the need for surgical intervention in large and complicated ALA even in malnourished children who present late for treatment.

F10-4 Current status on the treatment of amebic liver abscess

F10-4 Current status on the treatment of amebic liver abscess

Treatment of Amebic Liver Abscess with Oral and Intravenous Administration of Aureomycin and Terramycin

Treatment of Amebic Liver Abscess with Oral and Intravenous Administration of Aureomycin and Terramycin

AMEBIASIS OF THE LIVER: CLASSIFICATION, DIAGNOSIS AND TREATMENT

Article1 October 1946AMEBIASIS OF THE LIVER: CLASSIFICATION, DIAGNOSIS AND TREATMENTGERALD KLATSKIN, M.D.GERALD KLATSKIN, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-25-4-601 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptINTRODUCTIONAmebiasis of the liver is a disease of considerable interest and importance. Its protean clinical manifestations make it a difficult diagnostic problem at times, but early treatment has such an important bearing on prognosis that its prompt recognition is important. Unfortunately, most reports have emphasized the clinical picture of amebic abscess, usually a late manifestation of the disease, so that many cases go unrecognized and untreated.Numerous studies1have established the fact that amebiasis of the colon is a relatively common disease in the United States. The incidence is even higher in tropical and subtropical areas, where sanitation is...Bibliography1. OCHSNERDEBAKEY AM: Amebic hepatitis and hepatic abscess, Surgery, 1943, xiii, 460. Google Scholar2. KLATSKIN G: Unpublished data. Google Scholar3. PAYNE AM: Amoebic dysentery in Eastern India, Trop. Dis. Bull., 1945, xlii, 206. Google Scholar4. PALMER RB: Changes in the liver in amebic dysentery, Arch. Path., 1938, xxv, 327. Google Scholar5. ROGERS L: The rapid cure of amebic dysentery and hepatitis by hypodermic injections of soluble salts of emetine, Brit. Med. Jr., 1912, i, 1424. CrossrefGoogle Scholar6. ROGERS L: Amebic liver abscess, Lancet, 1922, i, 569. CrossrefGoogle Scholar7. BERNE CJ: Diagnosis and treatment of amebic liver abscess, Surg., Gynec. and Obst., 1942, lxxv, 235. Google Scholar8. ROGERS L: Recent advances in tropical medicine, 1929, P. Blakiston's Son and Co., Philadelphia. Google Scholar9. GREIG ED: Amebic abscess of the liver discharged through the lung, Jr. Trop. Med. and Hyg., 1940, xliii, 207. Google Scholar10. MELENEY HE: The pathology of amebiasis, Jr. Am. Med. Assoc., 1934, ciii, 1213. CrossrefGoogle Scholar11. ROGERS L: Amebic liver abscess, Lancet, 1922, i, 463. CrossrefGoogle Scholar12. CHEVERSMACLEAN N Quoted by SCOTT H. H.: A history of tropical medicine, 1939, The Williams and Wilkins Co., Baltimore. Google Scholar13. BROWNHODGSON PWCH: Late results of treatment of amebic abscess and hepatitis of the liver, Am. Jr. Med. Sci., 1938, cxcvi, 305. CrossrefGoogle Scholar14. KILGORE ES: Discussion of Elliott's paper, Trans. Assoc. Am. Phys., 1935, l, 176. Google Scholar15. MUNK J: X-ray appearances in amebic hepatitis, Brit. Jr. Radiol., 1944, xvii, 48. CrossrefGoogle Scholar16. PANCOAST HK: The roentgenological diagnosis of liver abscess with or without subdiaphragmatic abscess, Am. Jr. Roent., 1926, xvi, 303. Google Scholar17. OCHSNERDEBAKEY AM: Amebic hepatitis and hepatic abscess, Surgery, 1943, xiii, 612. Google Scholar18. NOTHHIRSHFELD PHJW: Amebic abscess of the liver with secondary infection. Local treatment with penicillin, Jr. Am. Med. Assoc., 1944, cxxiv, 643. CrossrefGoogle Scholar19. ROYSTERHAYWOODSTANFIELD HAHBWW: The treatment of amebic abscess of the liver, Ann. Surg., 1936, ciii, 794. CrossrefGoogle Scholar20. ELLIOTT CA: Importance of the therapeutic test for amebiasis in patients presenting symptoms referable to the right lower chest, Trans. Assoc. Am. Phys., 1935, l, 176. Google Scholar21. SODEMANLEWIS WABO: Amebic hepatitis, Am. Jr. Trop. Med., 1945, xxv, 35. CrossrefGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: New Haven, Connecticut*Received for publication October 12, 1945.From the Department of Internal Medicine, Yale University School of Medicine.†Formerly Chief of Medical Service, Schick General Hospital, Clinton, Iowa. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byA Refractory Case of Hepatic AmoebiasisA clinical comparison of amebic and pyogenic abscess of the liver in sixty-six patientsFever Patterns in a Case of Hepatic AmebiasisHepatic amoebiasisNutritional Factors in Liver Disease in ManAmebiasis of the liverBronchobiliary Fistulas Secondary to Amebic Abscess of LiverAMEBIASIS: CONTROLLED LINEAR STUDIES ON NONDYSENTERIC AND MILD HEPATIC FORMS IN EGYPTIANS*H. LEONARD JONES JR., M.D., F.A.C.P., GAMIL CASSIS, M.B., B. Ch., THOMAS M. FLOYD, B.S., M.S., N. S. MANSOUR, B.SC.DIAGNOSIS AND TREATMENT OF AMEBIC LIVER ABSCESS*RYLE A. RADKERenal Displacement and Pyelography Deformity Produced by Amebic Infection of the LiverAmebic Hepatitis Presenting as Fever of Unknown OriginAcute Liver Disease: Its Causes and TreatmentEXPERIENCES IN THE DIAGNOSIS AND ANTIBIOTIC THERAPY OF AMEBIASIS: AN ANALYSIS OF 50 CASES*NELSON J. WEISER, EUGENE SPIOTTA, PIERRE EKMANProblems in diagnosis and complications of amebic infection of the liverARTHRITIS DUE TO INTESTINAL AMEBIASIS*EMANUEL M. RAPPAPORT, M.D., A. X. ROSSIEN, M.D., LOUIS A. ROSENBLUM, M.D., F.A.C.P.Chronic Involvement of the Liver in Intestinal Amoebiasis. (Chronic Amoebic Hepatitis)Amebic Abscess of the LiverAmebiasis 1 October 1946Volume 25, Issue 4Page: 601-631KeywordsAmebiasisColonLiverLiver diseasesMedical servicesSanitation ePublished: 1 December 2008 Issue Published: 1 October 1946 PDF downloadLoading ...