[Ultrasonographic appearances of hepatic amebic abscesses. Findings in 22 cases]

Ultrasonographic findings in 22 patients with hepatic amebic abscesses are described. All patient were febrile, complained of pain in the liver region, and had a raised ESR with polymorphonucleosis, and enhanced immunofluorescence or hemagglutination. Initial ultrasonography demonstrated a preferential site for the lesion in the right side of the liver, with three non-specific types of image. Indirect signs and the severity of the disease could be determined. Patients were followed up during specific treatment with metronidazole by means of clinical, biological, and ultrasonographic examinations, confirmation of healing depending entirely upon clinical evidence of absence of hepatic signs. Three types of healing, as shown by ultrasonography, are described: the homogeneous hypoechogenic form, known as the slow healing form, can raise ultrasonographic diagnostic difficulties. Apart from routine straight radiography of the chest and abdomen, ultrasonography was, in the majority of cases, the only radiological examination conducted, even in cases of recurrence or relapse; it enables the puncture to be controlled directly. Scintigraphy and scanning were rarely employed, except when ultrasonography was ineffective, and arteriography was reserved for certain very particular differential diagnosis problems. An algorithm, employed for facilitating diagnosis of hepatic amebic abscesses, emphasizes the primary role played by ultrasonography.