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Amebic peritonitis secondary to amebic liver abscess

F C Eggleston, A K Handa, M Verghese

    Surgery
    |January 1, 1982
    PubMed
    Summary

    Ruptured amebic liver abscesses causing amebic peritonitis are rare but severe complications. Prompt surgical intervention is crucial, but the mortality rate remains high, especially in older patients or those with delayed diagnosis.

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    Area of Science:

    • Gastroenterology
    • Hepatology
    • Infectious Diseases

    Background:

    • Amebic liver abscess (ALA) is a common parasitic infection, but its rupture leading to amebic peritonitis is a rare and serious complication.
    • This study focuses on the clinical presentation, management, and outcomes of patients with amebic peritonitis secondary to a ruptured ALA.

    Purpose of the Study:

    • To present a series of patients with amebic peritonitis secondary to ruptured amebic liver abscess.
    • To analyze the clinical characteristics, surgical management, and mortality factors associated with this condition.

    Main Methods:

    • Retrospective review of 19 patients treated for amebic peritonitis secondary to ruptured ALA over an 18.5-year period.
    • Surgical management included removal of necrotic material, wide drainage, and in select cases, intestinal bypass.

    Main Results:

    • Amebic peritonitis represented 2.4% of ALA cases. The majority of patients were male, with ages ranging from 6 to 70 years.
    • Common symptoms included abdominal pain and fever; physical findings included abdominal tenderness, liver enlargement, distention, and jaundice.
    • The overall mortality rate was 42%, significantly higher in patients over 50 years and those with incorrect preoperative diagnosis.

    Conclusions:

    • Rupture of an amebic liver abscess leading to peritonitis is associated with high morbidity and mortality.
    • Early and accurate diagnosis, followed by prompt surgical intervention, is critical for improving patient outcomes.
    • Advanced age and delayed diagnosis are significant risk factors for increased mortality in amebic peritonitis.

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