Tropical Doctor > Tropical Doctor Online First > 10.1258/td.2009.090089

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Short Report

Amoebic liver abscess: experience in a south Asian country

A Rehman Alvi FRCS FCPS      Farrukh Rizvi MBBS     Syed Faraz Kazim MBBS     Kiran Ejaz      Hasnain Zafar FRCS     Tabish Chawla FRCS     Shahida Bibi FCPS     Zia Ur Rehman FCPS  

Department of Surgery, Aga Khan University Hospital, Stadium Road, PO Box 3500, Karachi, Pakistan

Correspondence to: Dr A Rehman Alvi, Department of Surgery, Aga Khan University Hospital, Stadium Road, PO Box 3500, Karachi, Pakistan Email: rehman.alvi{at}aku.edu

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.

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