Perforated amebic liver abscesses: successful percutaneous treatment

Area of Science:

• Hepatology
• Infectious Diseases
• Interventional Radiology

Background:

• Perforation of hepatic amebic abscesses presents significant morbidity and mortality risks.
• Historically, emergency surgery was the primary treatment for this severe complication.

Purpose of the Study:

• To evaluate the efficacy of percutaneous drainage for perforated hepatic amebic abscesses.
• To assess the role of catheter drainage as an alternative to surgery in critically ill patients.

Main Methods:

• Percutaneous catheter drainage was performed in five severely ill patients with perforated hepatic amebic abscesses.
• Drainage targeted multiple abscess locations, including intrahepatic and extrahepatic sites.
• Catheter drainage was combined with metronidazole therapy.

Main Results:

• Successful drainage of perforated hepatic amebic abscesses was achieved in all five patients.
• Multiple abscess cavities, including those in the subhepatic space, pelvis, chest, and retroperitoneum, were drained.
• Associated fistulas to the bile ducts, duodenum, and colon healed spontaneously.

Conclusions:

• Percutaneous catheter drainage is an effective treatment for perforated hepatic amebic abscesses.
• This minimally invasive approach expands treatment options for this serious complication, especially in high-risk patients.
• Spontaneous healing of associated fistulas suggests favorable outcomes with catheter drainage.