[Amebic liver abcess at Bouake Teaching Hospital: diagnostic and therapeutic aspects about 46 cases]

Abstract

Aims: To describe the diagnosis and therapeutic aspects of amebic liver abscesses.

Material and methods: Retrospective study of 46 cases of amebic liver abcesses seen at Bouaké Teaching Hospital during the period from January 1997 to June 2002.

Results: Three clinical pictures were carried out: painful and feverish hepatomegaly (n=28, 60.9%), fever with pain of the right hypochondrium (n=3, 6.5%) and diffuse acute peritonitis (n=15, 32.6%). Forty-one liver abcesses were diagnosed with abdominal ultrasonography and the remaining 5 cases were diagnosed during laparotomy. Fifteen patients had peritonitis due to rupture of liver abcesses and one among them had a gangrenous left colon. Amoebiasis was diagnosed by positive amebic serology among all patients. All the patients received antibiotic treatment, 16 patients were treated by needle aspiration under ultrasound and 15 patients underwent a laparotomy. Post-operative morbidity was of 4 parietal suppurations. Morbidity of needle aspiration was nil. One death occurs as the consequence of hepatocellular insufficiency.

Conclusion: This study stresses ultrasound examination place in the diagnosis and the treatment of amebic liver abscess. Laparotomy is still performed to deal with complicated forms such as intraperitoeal rupture.