AMOEBIC LIVER ABSCES

NEEDLE ASPIRATION AFTER 96 HOURS OF MEDICAL TREATMENT

Abstract

Background: Amoebic Liver Abscess (ALA) is a serious problem in Pakistan. Its management includes antimicrobial drugs, needle
aspiration and surgical drainage. Objective: To determine if amoebic liver abscess can be treated conservatively or requires needle aspiration
as well in selected cases. Design: a prospective hospital based study Setting: Nishtar Hospital Multan. Period: 18 months. Methods: Thirty
six consecutive adult patients with a right lobe liver abscess were included. All patients received metronidazole 800mg orally for 10-14 days
and were clinically observed. Patients who did not show any clinical improvement in 96 hours had an ultrasound guided needle aspiration
performed. Results & conclusion: Patients having an ALA less than 10 cm in size respond to medical treatment. If patients continue to have
toxic symptoms, needle aspiration should be performed. Most patients having ALA of >10 cm will end up having a needle aspiration but should
be given a trial of medical managemen