AMEBIC-ABSCESS OF THE LIVER - ULTRASOUND- GUIDED ASPIRATION

The aim of this study is to present the results of ultrasound-guided n eedle aspiration in amoebic abscess of the liver in 1289 patients. Out of 1512 patients hospitalized from 1990 to 1995 for an amoebic absces s of the liver, 1289 (83,6%) were treated by this approach. The absces ses of less than 40 mm (8,9%) were treated medically, and those of mor e than 170 mm (0,6%) were operated on. The abscesses with peritonitis (5,2%) were also operated on. A treatment with metronidazole or dehy d roemetin was associated with the surgical treatment or with the aspira tion of the abscess. There was no death. A second aspiration was neces sary in 24,9% of the patients, and a third one in 9,4%. Three complica tions were observed, two hemorrhages and one fistula. Nine patients ha d a recurrent abscess after their discharge from hospital. Four failur es were observed in patients with abscesses of more than 170 mm in dia meter. Results were considered as good in 1273 patients (98,7%). These results suggest that in amoebic abscess of the liver with a diameter between 40 and 170 mm, aspiration associated with amoebicid treatment may be the standard treatment. Smaller abscesses usually recover with medical treatment alone, and greater abscesses need surgical drainage.