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The Prognostic Factors of Severe Amebic Liver Abscess: a Retrospective Study of 125 Cases
Seng-Kee Chuah
Seng-Kee Chuah
Section of Gastroenterology, Department of Internal Medicine, Chang Gung Memorial Hospital, Kaohsiung, Taiwan, Republic of China
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Chi-Sin Chang-Chien
Chi-Sin Chang-Chien
Section of Gastroenterology, Department of Internal Medicine, Chang Gung Memorial Hospital, Kaohsiung, Taiwan, Republic of China
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I-Shyen Sheen
I-Shyen Sheen
Section of Gastroenterology, Department of Internal Medicine, Chang Gung Memorial Hospital, Kaohsiung, Taiwan, Republic of China
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Hsien-Hong Lin
Hsien-Hong Lin
Section of Gastroenterology, Department of Internal Medicine, Chang Gung Memorial Hospital, Kaohsiung, Taiwan, Republic of China
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Shue-Shian Chiou
Shue-Shian Chiou
Section of Gastroenterology, Department of Internal Medicine, Chang Gung Memorial Hospital, Kaohsiung, Taiwan, Republic of China
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Cheng-Tang Chiu
Cheng-Tang Chiu
Section of Gastroenterology, Department of Internal Medicine, Chang Gung Memorial Hospital, Kaohsiung, Taiwan, Republic of China
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Chung-Huang Kuo
Chung-Huang Kuo
Section of Gastroenterology, Department of Internal Medicine, Chang Gung Memorial Hospital, Kaohsiung, Taiwan, Republic of China
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Jye-Jou Chen
Jye-Jou Chen
Section of Gastroenterology, Department of Internal Medicine, Chang Gung Memorial Hospital, Kaohsiung, Taiwan, Republic of China
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King Wah Chiu
King Wah Chiu
Section of Gastroenterology, Department of Internal Medicine, Chang Gung Memorial Hospital, Kaohsiung, Taiwan, Republic of China
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One hundred twenty-five cases of amebic liver abscess were diagnosed at Chang Gung Memorial Hospital in Taiwan from January 1981 to December 1989. An analysis of possible prognostic factors for severe amebic liver abscess was done retrospectively. The majority of the patients came from the southern part of Taiwan. Severe amebic liver abscess was defined as the rupture of an abscess that was resistant to 72 hr of medical treatment, or complicated by secondary bacterial infection. The results showed significant differences between patients with severe liver abscess and those with more moderate forms of amebic liver abscess in indices such as jaundice, hemoglobin and serum bilirubin levels, and dyspnea, as well as in pulmonary changes (right diaphragm elevation, right pleural effusion) seen on chest radiographs. Those patients with diabetes mellitus also had greater evidence of severe liver abscess. Moderate cases that were treated with amebicides showed excellent responses (no mortality). Severe cases required, in addition to amebicide therapy, either percutaneous or surgical drainage of pus, especially in those patients with ruptured abscesses. Those patients with abscesses that ruptured into the thoracic cavity were treated by either thoracostomy or needle aspiration, and all were cured. Three patients died of abscess rupture into the abdominal cavity, associated with secondary bacterial infection. The overall mortality rate was 2.4%. These symptoms and signs of severe liver abscess are indicators of the need for intensive treatment such as aspiration or surgical drainage.
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| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 435 | 99 | 15 |
| Full Text Views | 23 | 2 | 0 |
| PDF Downloads | 17 | 2 | 0 |