[Ultrasonography of amebic liver abscesses. Proposal of a new classification]

The different classifications used for amebic liver abscesses seem to be usually without direct therapeutic benefit. Echographic assessment was used to propose a new classification of amebic liver abscesses. This report is a prospective study conducted over 3 years and concerning 118 patients involved by 119 amebic liver abscesses. They were 109 males and 9 females aged from 13 to 68 years (mean, 36 years). All cases were correctly diagnosed by clinical and ultrasound findings, aspect of the pus, course under treatment and rarely by serologic examinations (3 patients). Patients were followed up with clinical and sonographic examinations as requested. Our classification was based on the initial echographic examination findings, the therapeutic indications and the type of healing obtained. In total, 93 abscesses (80, 67%) were treated by medical therapy alone and 26 cases (21, 84%) by combined US-guided evacuation and medical therapy. In the 119 abscesses, 112 (94, 11%) completely recovered with reconstitution of a normal liver parenchyma. In the remaining 7 cases (5, 88%) the abscesses persisted for several months (12 to 36 months). Our study suggests that ultrasonographic features of amebic liver abscesses can be segregated in three forms: noncollected form which needs to be treated by medical therapy alone, collected form which can be treated medically or by association with US-guided evacuation, and the healing forms. This classification appears to us to be simple but very precise, reliable and useful especially for therapeutic indications of amebic liver abscesses.