Experience with aspiration in cases of amebic liver abscess in an endemic area |
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Authors: | S Khanna D Chaudhary A Kumar J C Vij |
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Institution: | (1) Department of Gastroeneterology and Hepatology, Pushpawati Singhania Research Institute for Liver, Renal and Digestive Diseases, Press Enclave Road, Shiekh Sarai-II, New Delhi, 110017, India;(2) Department of Imaging and Radiodiagnosis, Pushpawati Singhania Research Institute for Liver, Renal and Digestive Diseases, Press Enclave Road, Shiekh Sarai-II, New Delhi, 110017, India |
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Abstract: | The study presented here was performed to evaluate the need for aspiration in patients with amebic liver abscess (ALA). Patients older than 12 years with a diagnosis of ALA based on clinical features, ultrasound results, and positive amebic serology were included in the study (n=144). Serological testing was performed to detect the presence of immunoglobin G antibody against Entamoeba histolytica, and a value of more than 0.4 optical density units was considered positive. All patients were given intravenous metronidazole (500 mg every 8 h) and their clinical progress and need for abscess aspiration was documented. Fever, pain in the upper abdomen, and tender hepatomegaly was seen in 133 (92.3%), 128 (88.8%), and 144 (100%) patients, respectively. Multiple abscesses were seen in 40 (27.7%) patients. Six (4.1%) patients died. Seventy-one (49.3%) patients responded to metronidazole alone. A total of 73 (50.69%) patients required aspiration of the abscess. This study shows that almost 50% of the patients with amebic liver abscess failed to respond to metronidazole and required aspiration. |
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