Amoebic liver abscess surgery
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Surgery is not the mainstay of treatment. It is rarely required.
Percutaneous needle aspiration
- Absence of clinical response
- Worsening pain, tenderness, and jaundice
- Abscess with high risk of peritoneal or pericardial rupture (>10cm located in left liver lobe)
- Differentiate pyogenic from amoebic liver abscess
- Deterioration while in medical therapy
- Initial negative serology
- Non compliance for medical therapy
- Percutaneous needle aspiration is mostly recommended for large abscesses.
- This method is indicated when the abscess is not getting aspirated with needle or failure of ultrasound guided aspiration
Surgical open drainage
Surgical open drainage is rarely required and Indicated in the following conditions:
- Clinical deterioration despite attempted needle aspiration
- Complicated amoebic liver abscess (like ruptured abscess in peritoneal cavity with features of peritonitis, ruptured abscess in the pleural cavity/pericardial cavity/adjacent viscera)
- Large abscess with a poor yield on needle aspiration or percutaneous drainage
- vanSonnenberg E, Mueller PR, Schiffman HR, Ferrucci JT, Casola G, Simeone JF; et al. (1985). "Intrahepatic amebic abscesses: indications for and results of percutaneous catheter drainage". Radiology. 156 (3): 631–5. doi:10.1148/radiology.156.3.4023220. PMID 4023220.
- Aucott JN, Ravdin JI (1993). "Amebiasis and "nonpathogenic" intestinal protozoa". Infect Dis Clin North Am. 7 (3): 467–85. PMID 8254155.