A Study on Clinical Presentation, Surgical Complications and Management of Amoebic Liver Abscess Cases over a Period of 2 Years, in GSL Medical College, Rajahmundry

Amoebiasis is largely a disease of tropical and developing countries. Two species of amoeba infect humans, entamoeba dispar is associated with an asymptomatic carrier state and not with disease. Amebic liver abscess is the most common extra intestinal form of invasive amebiasis. It follows a bimodal age distribution (2-3 years and over 40 years), low socioeconomic status; heavy alcohol consumption is commonly reported and may render the liver more susceptible to amebic infection. Patients more likely present with abdominal pain, diarrhea, and hepatomegaly. The first line treatment in uncomplicated amebic abscess should be amebicidial drugs, aspiration and surgical intervention is needed in complicated cases. In our study of 34 patients, amoebiac liver abscess was common in men aged more than 40 years from low socio economic group and alcoholics. Majority (41.1 %) of the patients presented with pain abdomen with fever and tenderness in the right hypochondrium. The most common complication was rupture into peritoneum which was managed surgically by emergency laparotomy and drainage, out of the three patients who developed pleural complications two were managed with ICD and one patient who developed empyema underwent decortication. One patient who developed cardiac tamponade, a rare complication was treated with pericardiocentesis.