Outcome of hepatic amebic abscesses managed with three different therapeutic strategies |
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Authors: | Dr Carlo Filice Giovanni Di Perri Maurizio Strosselli Enrico Brunetti Stefano Dughetti David H Van Thiel Carlo Scotti-Foglieni |
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Institution: | (1) Department of Infectious Diseases and Department of Surgery, University of Pavia School of Medicine and Surgery, IRCCS Ospedale Policlinico San Matteo , 27100 Pavia, Italy;(2) Department of Medicien and Department of Surgery, University of Pittsburgh School of Medicine, 15261 Pittsburgh, Pennsylvania;(3) Istituto di Clinica delle Malattie Infettive dell'Universita' di Pavia, IRCCS-Ospedale Policlinico San Matteo , Piazzale Golgi n. 2, 27100 Pavia, Italy |
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Abstract: | Three different approaches to hepatic abscesses due toEntamoeba histolytica were compared in 51 patients. The three modes of therapy utilized were: medical therapy with nitroimidazoles(N=11 patients), open surgical drainage (N=9 patients), and percutaneous drainage using ultrasound guidance followed by intralesional nitroimidazole administration (N=31 patients). The results with each form of therapy were assessed clinically and by abdominal ultrasound. Patients receiving combined US-guided drainage and intralesional chemotherapy experienced a faster and overall better clinical response, which was confirmed also by sonographic follow-up of the hepatic lesions. This better response was associated with faster resolution, fewer relapses, and less residual hepatic scarring than either with medical therapy alone or open surgical drainage combined with medical therapy. |
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Keywords: | hepatic amebic abscess ultrasonography nitroimidazoles surgical drainage percutaneous drainage |
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