[Amoebic liver abscess in general surgery at the Gabriel Touré teaching hospital, Bamako, Mali]

The objectives were to determine the frequency, and to describe the clinical and therapeutic aspects of amoebic liver abscess. This was a retrospective study in the general surgery department of the Gabriel Touré teaching hospital from 1 January 2004 to December 2008. Included in this study, were all patients hospitalized and treated for amoebic liver abscess. We collected 53 cases a frequency of 1.3%. This was 45 men (84.9%) and 8 women (15.1%). The sex ratio was 5.6. The average age was 39.5 years. The average consultation time was 3 weeks. The signs observed were fever 96.2% (51 cases), the hepatalgia 94.3% (50 case), hepatomegaly 90.6% (48 cases) and anorexia 88.7% (47 cases). Collections of objectified abscess in abdominal ultrasound were located in the right lobe in 79.2% (42 cases), unique in 92.5% (49 cases) and 100 mm in diameter on average. Pulmonary radiography found an elevation of the right diaphragmatic dome 66.7% (14 cases). Amoebic serology was performed in 60.4% of cases, was negative in 2 cases (6.2%). Medical treatment alone was effective in the majority of cases - 62.7% (32 cases), an ultrasound-guided paracentesis associated with medical treatment was required in 31.4% (16 cases). Surgical methods were very rarely recommended 5.9 % (3 cases). The average amount of pus was 637.6ml. Average duration of treatment was 11 days. We recorded three deaths, including one due to a sepsis on peritonitis from ruptured liver abscess and 2 cases due to HIV.

The amoebic liver abscess is uncommon in our service. Negative serology does not exclude the diagnosis. Medical treatment is usually curative in the absence of complications.