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. |
