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The results of surgery in amebic liver abscess: experiences in eighty-three patients
Abstract:
Experiences with surgery in 83 patients with amebic liver abscess are presented. The patients' ages ranged from 8 months to 72 years; 85% were men. Symptoms had been present for an average of 4.6 weeks. In 36 (43%) the abscess already was ruptured at the time of admission to the hospital and in an additional eight it ruptured later. Rupture occurred more commonly upward through the diaphragm than downward, and into a serous cavity in 36 patients. Because of the poor general condition and associated illnesses of the patients, surgical procedures were limited to the minimum. Indications for operation were rupture or impending rupture of the abscess, failure of response to medical therapy, and inadequacy of aspiration of left lobe abscess. An additional 27 patients underwent operation because of diagnostic problems or symptoms of an acute abdomen. Two thirds of the patients had one or more complication. The overall mortality rate was 34%. Factors adversely affecting mortality rate were lack of preoperative drug therapy, rupture into a serous cavity, and presence of an associated amebic perforation of the colon.
Insights
Surgery for amebic liver abscess (ALA) in 83 patients revealed high complication rates. Rupture, especially into serous cavities, and lack of preoperative therapy significantly increased mortality in this surgical experience.
Area of Science:
- Hepatology
- Infectious Diseases
- Surgical Gastroenterology
Background:
- Amebic liver abscess (ALA) is a serious condition often requiring intervention.
- Surgical management is considered for complicated or refractory cases.
Purpose of the Study:
- To present surgical experiences with amebic liver abscess.
- To identify factors influencing outcomes and mortality.
Main Methods:
- Retrospective review of 83 patients undergoing surgery for ALA.
- Analysis of patient demographics, symptoms, surgical indications, complications, and mortality.
Main Results:
- 85% of patients were male, with a wide age range.
- 43% of abscesses were ruptured on admission; rupture into serous cavities occurred in 36 patients.
- Overall mortality was 34%, with complications in two-thirds of patients.
Conclusions:
- Surgical intervention for ALA is associated with significant morbidity and mortality.
- Rupture into a serous cavity, lack of preoperative drug therapy, and colonic perforation are poor prognostic factors.