Amoebic liver abscess: experience in a south Asian country.
Amoebic liver abscess (ALA) is endemic in south Asian countries. The current study was undertaken in order to evaluate the clinical spectrum, management and outcome of ALA at an urban tertiary care hospital in Pakistan. The chart notes of 232 ALA patients admitted from 1 January 2000 to 31 August 2007 were retrospectively reviewed. The most frequent clinical findings included: fever (96.5%); right upper abdomen pain (80.2%); liver tenderness (73.5%); tachycardia (61.6%); hepatomegaly (60%); nausea and vomiting (42%); and jaundice (23.9%). The duration of symptoms was less than 14 days in 70% . Ultrasound examinations revealed 69% of the abscesses were in the right lobe, 19% in the left lobe and 12% in both lobes. The size of the abscess was greater than 5.0 cm in 83%. Seventy-seven percent of the patients had a single abscess and 23% had multiple abscesses. Ultrasound-guided therapeutic aspiration was performed in 64%, but 36% were treated with antibiotics alone. Metronodazole was the most frequently used antibiotic. However, various combinations of antibiotics were also used without any obvious justification.
Department of Surgery, Aga Khan University Hospital, Stadium Road, PO Box 3500, Karachi, Pakistan. rehman.alvi@aku.edu
A
A
Rehman Alvi
Farrukh
F
Rizvi
Syed Faraz
SF
Kazim
Kiran
K
Ejaz
Hasnain
H
Zafar
Tabish
T
Chawla
Shahida
S
Bibi
Zia
Z
Ur Rehman
D015746:Abdominal Pain / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000188:drug therapy; D000818:Animals; D000890:Anti-Infective Agents / Q000627:therapeutic use*; D003131:Combined Modality Therapy / Q000379:methods; D005260:Female; D005334:Fever / Q000175:diagnosis / Q000188:drug therapy; D006529:Hepatomegaly / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000188:drug therapy; D006786:Hospitals, Urban; D006801:Humans; D008101:Liver Abscess, Amebic / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000503:physiopathology; D008297:Male; D008795:Metronidazole / Q000627:therapeutic use*; D008875:Middle Aged; D009325:Nausea / Q000175:diagnosis / Q000188:drug therapy; D010154:Pakistan; D013997:Time Factors; D016896:Treatment Outcome; D014463:Ultrasonography; D014839:Vomiting / Q000188:drug therapy
D000890:Anti-Infective Agents; D008795:Metronidazole