Ultrasound patterns and frequency of focal liver lesions after successful treatment of amoebic liver abscess.
OBJECTIVE
To evaluate the frequency and morphology of residual liver lesions in patients successfully treated for amoebic liver abscess.


METHODS
Retrospective ultrasound-based study of 240 adult males from an amoebiasis-endemic area in Vietnam with a documented clinical history of amoebic liver abscess. Subjects were re-examined by hepatic ultrasound 1-13 years after abscess treatment.


RESULTS
In 17 subjects (7.1%) focal hypo- or isoechoic areas were identified within the liver with a diameter of 8-48 mm surrounded by a hyperechoic wall. These lesions were associated with positive amoeba serology, were located at the site of the previous abscess and their sonographic appearances corresponded to post-amoebic liver abscess residues. Residues were found in all groups of patients irrespectively of the time-span since the abscess was treated. However, lesions older than 7 years showed some degree of calcification. Otherwise, lesions were apparently inactive, as patients had no clinical symptoms or signs of inflammation and follow-up after one year revealed no changes in size or pattern.


CONCLUSIONS
The vast majority of amoebic liver abscesses resolve to a sonographically normal parenchymal pattern. However, in a small proportion of cases characteristic residues remain. These residues do not require further treatment or diagnostic intervention and should be considered in the differential diagnosis of space-occupying liver lesions, in particular in patients from amoebiasis-endemic areas.
Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany.
Joerg
J
Blessmann
Nguyen Dinh
ND
Khoa
Le
L
Van An
Egbert
E
Tannich
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000981:Antiprotozoal Agents / Q000627:therapeutic use; D019353:Endemic Diseases; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging*; D008101:Liver Abscess, Amebic / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000453:epidemiology; D008297:Male; D008795:Metronidazole / Q000627:therapeutic use; D008875:Middle Aged; D012189:Retrospective Studies; D014463:Ultrasonography; D014744:Vietnam / Q000453:epidemiology
D000981:Antiprotozoal Agents; D008795:Metronidazole