Experiences with grey scale ultrasonography in hepatic amoebiasis

Ultrasound examination was conducted in 151 proven cases of amoebic liver abscess. In the majority of patients the lesion was solitary but 25% of patients had multiple lesions; 17% of all the abscesses were in the left lobe of the liver. Most abscesses had no, or very few internal echoes and these were either of the same density as the normal liver (15%) or less dense (84%). In all cases there were relatively fewer echoes in the lesion. Abscesses in critical areas were accurately located especially in relation to the pericardium. Other liver lesions such as hepatoma which may enter into the clinical diagnosis can be recognised. Ultrasound has particular value in accurate localisation of the lesion for aspiration, demonstration of unsuspected multiple abscesses and size estimation in serial studies of the patient under treatment. The diagnostic errors were mainly due to initial inexperience and demonstrated some of the diagnostic pitfalls. It is concluded that the introduction of this technique has proved to be of considerable value in the diagnosis and management of amoebic liver abscess in our area, where the disease is still a major clinical entity. If diagnosed early and treated adequately the condition has an excellent prognosis.