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Management of amoebic peritonitis due to ruptured amoebic liver abscess: It's time for a paradigm shift

Ramesh Kumar1, Utpal Anand2, Rajeev N Priyadarshi3

  • 1Department of Gastroenterology All India Institute of Medical Sciences Patna India.

JGH Open : an Open Access Journal of Gastroenterology and Hepatology
|July 6, 2019
PubMed

Insights

Ruptured amoebic liver abscess (ALA) with peritonitis is dangerous. Percutaneous catheter drainage (PCD) offers a promising, potentially less fatal, alternative to surgery for managing this critical condition.

Area of Science:

  • Gastroenterology
  • Infectious Diseases
  • Surgical Innovation

Background:

  • Amoebic liver abscess (ALA) rupture leading to peritonitis is a rare but severe complication.
  • High mortality rates (20-50%) are associated with surgical management of ruptured ALA with diffuse amoebic peritonitis.
  • Optimal management strategies for this condition remain debated.

Purpose of the Study:

  • To review the current understanding and emerging data on managing ruptured amoebic liver abscess with diffuse amoebic peritonitis.
  • To evaluate the efficacy and safety of percutaneous catheter drainage (PCD) as a therapeutic option.

Main Methods:

  • Literature review of cases reporting amoebic peritonitis secondary to ruptured ALA.
  • Analysis of mortality rates associated with different management approaches (surgical vs. PCD).

Main Results:

  • Emerging data suggest percutaneous catheter drainage (PCD) is a viable and potentially superior option.
  • PCD may offer a reduced mortality rate compared to traditional surgical interventions.

Conclusions:

  • Percutaneous catheter drainage (PCD) represents a significant advancement in managing ruptured ALA with diffuse amoebic peritonitis.
  • PCD is suggested as the preferred management strategy for this critical patient group.

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