MANAGEMENT OF RESISTANT AMOEBIC OVER ABSCESS
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Resistance to drug treatment is a definite problem in the management of patients with amoebic liver abscess. Twentypatients having resistant amoebic liver abscess (failure to respond to medical treatment after 5-10 days) were referred to our hospital (K.S.H.) from other regional hospitals. ^Ninety per cent of the patients were males. Their mean age was 32 y, 75% were Indians. Sixty per cent of the patients had an acute illness, the remaining had a more chronic illness. Hepatomegaly and hep^tic tenderness were found in 90% of the patients and fever in 45% of them. Diagnosis was confirmed by high titer of amoebic antibodies. The abscess was demonstrated by U.S. in all the patients, 20% of them needed additional C.T. scan. The mean abscess diameter was 10.9 cm, 95% were solitary and in the right lobe. All our patients underwent percutaneous catheter drainage under U.S. or C.T. guidance with closed system drainage. They also received full course of I.V. metronidazole. The drainage was examined daily microscopically (for detection of amoeba and other micro-organisms) and grosr ly (for amount and colour). The catheters were removed on the basis of clinical, radiological (U.S. and cavitogram) and catheter criteria.