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Amoebic liver abscess: the effect of aspiration on the resolution or healing time
O Freeman1, A Akamaguna, L N Jarikre
1University of Benin Teaching Hospital, Nigeria.
Abstract:
Recent sonographic monitoring of patients treated for amoebic liver abscess has shown the healing or resolution time varying between 10 and 300 days. The effect of percutaneous needle aspiration under or resolution time was studied in 36 patients. Nineteen patients had drugs and needle aspiration under ultrasound guide whilst the 17 patients had drugs--metronidazole, diloxanide, and chloroquine--alone. Both groups were monitored clinically and sonographically. Results showed that the abscess cavities of 18 out of 19 patients (94.7%) of the aspirated group and 10 of 17 patients (58.8%) of the non-aspirated group had resolved at the end of three weeks. The difference in response to treatment was significant (P less than 0.02) more so for lesion size more than 6 cm (P less than 0.01). There was also a more rapid clinical response in the aspirated group than in the non-aspirated group, particularly for patients whose lesion size was more than 6 cm (P less than 0.01). In conclusion, percutaneous needle aspiration is safe, enhances clinical recovery, and accelerates resolution particularly in patients with large abscess cavities.
Insights
Percutaneous needle aspiration significantly speeds up amoebic liver abscess resolution. This ultrasound-guided procedure enhances clinical recovery, especially for larger abscesses, compared to medication alone.
Area of Science:
- Hepatology
- Infectious Diseases
- Medical Imaging
Background:
- Amoebic liver abscess (ALA) treatment duration varies widely, from 10 to 300 days.
- Standard treatment involves antiparasitic drugs, but resolution times can be prolonged.
Purpose of the Study:
- To evaluate the impact of percutaneous needle aspiration on the resolution time of amoebic liver abscess.
- To compare clinical and sonographic outcomes between patients treated with drugs plus aspiration and those treated with drugs alone.
Main Methods:
- A study involving 36 patients with amoebic liver abscess.
- Nineteen patients received ultrasound-guided percutaneous needle aspiration and medication; 17 received medication alone.
- Clinical and sonographic monitoring was conducted for both groups.
Main Results:
- Abscess resolution by three weeks was achieved in 94.7% of the aspirated group versus 58.8% of the non-aspirated group.
- The difference in treatment response was statistically significant (P < 0.02), particularly for lesions >6 cm (P < 0.01).
- The aspirated group showed a more rapid clinical response, especially for larger lesions (P < 0.01).
Conclusions:
- Percutaneous needle aspiration is a safe and effective adjunct to medical therapy for amoebic liver abscess.
- Aspiration accelerates clinical recovery and hastens abscess resolution, particularly in cases of large abscess cavities (>6 cm).
- Ultrasound-guided aspiration improves treatment outcomes for amoebic liver abscess.