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Amebic hepatic abscess in children

G Porras-Ramírez1, M H Hernández-Herrera, J D Porras-Hernández

  • 1Unidad de Cirugía, Unidad Hospitalaria La Paz, Puebla, Mexico.

Journal of Pediatric Surgery
|May 1, 1995
PubMed
Summary

Medical treatment is effective for small amebic hepatic abscesses in children. Percutaneous needle aspiration successfully managed impending complications, while surgery was reserved for ruptured cases.

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Area of Science:

  • Pediatric Infectious Diseases
  • Hepatology
  • Medical Parasitology

Background:

  • Amebic hepatic abscess (AHA) is a serious infection caused by Entamoeba histolytica.
  • Prompt diagnosis and appropriate management are crucial for favorable outcomes in pediatric patients.
  • Treatment strategies for AHA have evolved, necessitating an understanding of their efficacy in different clinical scenarios.

Purpose of the Study:

  • To evaluate the treatment outcomes of pediatric amebic hepatic abscesses.
  • To determine the effectiveness of medical management, percutaneous needle aspiration, and surgical intervention.
  • To identify factors predicting the need for invasive procedures.

Main Methods:

  • Retrospective review of pediatric patients diagnosed with amebic hepatic abscess between 1975 and 1993.
  • Analysis of treatment modalities including medical therapy (dehydroemetine and metronidazole), percutaneous needle aspiration, and surgery.
  • Assessment of clinical presentation, abscess characteristics, and patient outcomes.

Main Results:

  • A total of 32 children (20 boys, 12 girls) were treated for AHA.
  • Medical treatment alone was effective for uncomplicated, small abscesses (17 patients).
  • Percutaneous needle aspiration was successful in 9 patients with impending complications, evidenced by clinical worsening, large abscess size (>6 cm) in septic patients, or signs of impending rupture.
  • Fifteen patients (47%) experienced abscess rupture, requiring surgical intervention, with one mortality due to sepsis.

Conclusions:

  • Medical management with dehydroemetine and metronidazole is highly effective for small, uncomplicated amebic hepatic abscesses in children.
  • Percutaneous needle aspiration is a safe and effective intervention for pediatric AHA with signs of impending rupture or complications.
  • Surgical intervention should be reserved for cases of ruptured amebic hepatic abscesses to minimize morbidity and mortality.

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