title: Catheter drainage versus needle aspiration in management of large (>10 cm diameter) amoebic liver abscesses.
abstract: OBJECTIVE
  To compare the effectiveness of percutaneous catheter drainage (PCD) and percutaneous needle aspiration (PNA) in the management of large (>10 cm diameter) amoebic liver abscesses.
  
  
  METHODS
  Eighty-two patients with amoebic liver abscess were randomly allocated to PCD (n = 42) or PNA (n = 40). Intervention was done under ultrasonography (US) [mainly] or computed tomography guidance within 24 h of admission. PNA was repeated every 3rd day if the cavity size had not reduced to 50% of the original size, for up to three times. Persistence of cavity or of clinical symptoms was considered failure of treatment. Duration to attain clinical relief, duration of hospital stay, complications, treatment failure and deaths were recorded.
  
  
  RESULTS
  PNA was successful in 32 (80%) patients (one aspiration in 4, two in 18 and three in 10 patients), while PCD was successful in 38 (90.5%) patients. Durations to attain clinical relief and parentral antibiotics required were significantly lesser in the PCD group. Hospital stay, although did not differ significantly, was lesser for PCD group. The only procedure-related complication due to PCD was rupture of abscess in two cases, leading to sepsis and death of one patient. Complications of PNA included pleural injury in one patient, and haemorrhage leading to subcapsular hematoma in another.
  
  
  CONCLUSIONS
  PCD is a better treatment option than PNA for the management of large (>10 cm diameter) amoebic liver abscess, in terms of duration to attain clinical relief and duration for which parentral antibiotics were needed.
authors.affiliation: Department of Surgery, MGM Medical College & MY Hospital, Indore, India. drguptashilpi@gmail.com
authors.forename: Shilpi Singh
authors.initials: SS
authors.lastname: Gupta
authors.forename: Onkar
authors.initials: O
authors.lastname: Singh
authors.forename: Glossy
authors.initials: G
authors.lastname: Sabharwal
authors.forename: Ankur
authors.initials: A
authors.lastname: Hastir
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002404:Catheterization; D004322:Drainage / Q000379:methods; D005260:Female; D006801:Humans; D008101:Liver Abscess, Amebic / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009339:Needles; D013396:Suction; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents