Amoebic liver abscess surgery
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Yamuna Kondapally, M.B.B.S[2]
Overview
Surgery
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
- Pregnancy
- 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
References
- ↑ 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.