Volume 78, Issue 4
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645


Jaundice in patients with amoebic liver abscess is a frequent occurrence. However, the pathophysiology of jaundice in these patients is not fully understood. Hepatic necrosis leads to damage to bile ducts as well as various vascular structures, which in turn leads to biliovascular fistula and jaundice. We studied the mechanism of jaundice in patients with amoebic liver abscess. We prospectively evaluated 12 patients with amoebic liver abscess and jaundice from February 2002 to August 2007. All patients underwent various investigations, including imaging studies. There were 11 males and 1 female patient with a mean age of 41.3 years. Mean duration of illness before presentation was 13.8 days. All patients had fever and jaundice. We detected damaged hepatic veins and bile ducts in all patients with amoebic liver abscess causing biliovascular fistula and hyperbilirubinemia, which reverted to normal after biliary diversion with nasobiliary drainage. Jaundice in patients with amoebic liver abscess is caused by biliovascular fistula resulting from hepatic necrosis leading to damage to bile ducts and hepatic veins.


Article metrics loading...

The graphs shown below represent data from March 2017
Loading full text...

Full text loading...



  1. Chhetri MK, Chakravorty NC, Neelakantan C, Bhattachrya B, Sarkar SK, 1969. Hepatic amoebiasis and its treatment with metronidazole. J Assoc Physicians India 17 : 681–688. [Google Scholar]
  2. Lamont NM, Pooler NR, 1958. Hepatic amoebiasis: a study of 250 cases. Q J Med 27 : 389–395. [Google Scholar]
  3. Vakil BI, Mehta AJ, Desai HN, 1970. Atypical manifestations of amoebic liver abscess. J Trop Med Hyg 73 : 63–74. [Google Scholar]
  4. Aptekar SI, Sood ID, 1970. Amoebic abscess of the liver. Indian J Surg 32 : 169–176. [Google Scholar]
  5. Dutta DV, Saha S, Samant A, Singh MD, Aikat BK, Chuttani PN, 1973. The clinical pattern and prognosis of patients with amoebic liver abscess. Am J Dig Dis 18 : 887–892. [Google Scholar]
  6. Joshi VR, Kapoor OP, Purohit AV, Nathani AN, Lele RD, 1972. Jaundice in amoebic liver abscess. J Assoc Physicians India 20 : 761–768. [Google Scholar]
  7. Nigam P, Gupta AK, Kapoor KK, Sharan GR, Goyal BM, Joshi LD, 1985. Cholestasis in amoebic liver abscess. Gut 26 : 140–145. [Google Scholar]
  8. Dutta DV, Chuttani PN, 1971. Cholestasis in patients with amoebic liver abscess. Am J Dig Dis 16 : 977–985. [Google Scholar]
  9. Dutta DV, 1977. Amoebic liver abscess with cholestasis. J Assoc Physicians India 20 : 907–912. [Google Scholar]
  10. Subramanian R, Madangopalan N, 1970. Amoebiasis Monograph. Bombay, India: Sandoz India.
  11. Hazra DK, Seth HC, Elhence GP, 1970. Jaundice in amoebic liver abscess. J Ind Med Assoc 55 : 244–250. [Google Scholar]
  12. Stanley SL Jr, 2003. Amoebiasis. Lancet 361 : 1025–1034. [Google Scholar]
  13. Rajak CL, Gupta S, Jain S, Chawla Y, Gulati M, Suri M, 1998. Percutaneous treatment of liver abscess: needle aspiration versus catheter drainage. AJR 170 : 1035–1039. [Google Scholar]
  14. Sandblom P, 1987. Hemobilia. In: Way LW, Pellegrini CA, eds. Surgery for the Gallbladder and Bile Ducts. Philadelphia: WB Saunders, 643–654.
  15. Glaser K, Wetscher G, Pointner R, Schwab G, Tschmelitsch J, Gadenstatter M, 1994. Traumatic bilhemia. Surgery 116 : 24–27. [Google Scholar]
  16. Struyven J, Cremer M, Pirson P, Jeanty P, Jeanmart J, 1982. Posttraumatic bilhemia: diagnosis and catheter therapy. AJR Am J Roentgenol 138 : 746–747. [Google Scholar]
  17. Gable DR, Allen JW, Harrell DJ, Carrillo EH, 1997. Endoscopic treatment of posttraumatic “bilhemia”: case report. J Trauma 43 : 534–536. [Google Scholar]
  18. Bose SM, Mazumdar A, Singh V, 2000. Non-operative management of gunshot injury of liver causing bilhemia. Aust NZ J Surg 70 : 382–384. [Google Scholar]
  19. Singh V, Narasimhan KL, Verma GR, Singh G, 2007. Endoscopic management of traumatic hepatobiliary injuries. J Gastroenterol Hepatol 22 : 1205–1209. [Google Scholar]
  20. Spahr L, Sahai A, Lahaie R, Dufresne MP, Bui BT, Dagenais M, Fenyves D, Layrargues P, 1996. Transient healing of TIPS—induced biliovenous fistula by PTFE-covered stent graft. Dig Dis Sci 41 : 2229–2232. [Google Scholar]
  21. Sears RJ, Ishitani MB, Bickston SJ, 1997. Endoscopic diagnosis and therapy of a case of bilhemia after percutaneous liver biopsy. Gastrointest Endosc 46 : 276–279. [Google Scholar]
  22. Verhille MS, Munoz SJ, 1991. Acute biliary–vascular fistula following needle aspiration of the liver. Gastroenterology 101 : 1731–1733. [Google Scholar]
  23. Foutch PG, Harian JR, Hoefer M, 1993. Endoscopic therapy for patients with a postoperative biliary leak. Gastrointest Endosc 39 : 416–421. [Google Scholar]
  24. Bjorkman DJ, Carr-Locke DL, Lichtenstein DR, 1995. Postsurgical bile leaks: endoscopic obliteration of the transpapillary pressure gradient is enough. Am J Gastroenterol 90 : 2128–2133. [Google Scholar]
  25. Chow S, Bosco JJ, Heiss FW, Shea JA, Qaseem T, Howell D, 1997. Successful treatment of post cholecystectomy bile leaks using nasobiliary tube drainage and sphincterotomy. Am J Gastroenterol 92 : 1839–1843. [Google Scholar]

Data & Media loading...

  • Received : 10 Oct 2007
  • Accepted : 26 Jan 2008

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error