title: Percutaneous catheter drainage of amebic liver abscesses with and without intrahepatic biliary communication: a comparative study.
abstract: Influence of communication with the intrahepatic biliary system on the clinical picture of amebic liver abscesses in 33 consecutive patients resistant to medical therapy, and their response to percutaneous catheter drainage was evaluated. Abscess-biliary communication was found in 27% of the sample. Patients with abscesses communicating with the biliary tree presented more frequently with jaundice (67% vs. 0%, P < 0.005), with a longer duration of illness (median 20 vs. 12 days, P < 0.001), had larger lesions (median 600 vs. 320 ml, P < 0.001) and required catheter drainage for longer periods (median 17 vs. 6.5 days, P < 0.000001). However the presence of a biliary communication did not materially affect the cure rate with catheter drainage (89% vs 100%, P > or = 0.05). In conclusion, an abscess-biliary communication is not uncommon in refractory amebic liver abscesses, and can be clinically detected by the presence of jaundice. Though a prolonged period of drainage may be necessary in the presence of this complication, catheter drainage can be expected to result in cure.
authors.affiliation: Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
authors.forename: D K
authors.initials: DK
authors.lastname: Agarwal
authors.forename: S S
authors.initials: SS
authors.lastname: Baijal
authors.forename: S
authors.initials: S
authors.lastname: Roy
authors.forename: B R
authors.initials: BR
authors.lastname: Mittal
authors.forename: R
authors.initials: R
authors.lastname: Gupta
authors.forename: G
authors.initials: G
authors.lastname: Choudhuri
mesh_terms: D000328:Adult; D001653:Bile Ducts, Intrahepatic / Q000000981:diagnostic imaging; D001658:Biliary Fistula / Q000000981:diagnostic imaging / Q000209:etiology*; D016022:Case-Control Studies; D002404:Catheterization / Q000379:methods; D002780:Cholestasis, Intrahepatic / Q000000981:diagnostic imaging / Q000209:etiology; D004322:Drainage / Q000379:methods*; D005260:Female; D006801:Humans; D008101:Liver Abscess, Amebic / Q000150:complications* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011877:Radionuclide Imaging; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome