PERCUTANEOUS CATHETER DRAINAGE OF AMEBIC LIVER-ABSCESSES WITH AND WITH OUT INTRAHEPATIC BILIARY COMMUNICATION - A COMPARATIVE-STUDY

Influence of communication with the intrahepatic biliary system on the clinical picture of amebic liver abscesses in 33 consecutive patients resistant to medical therapy, and their response to percutaneous cath eter drainage was evaluated. Abscess-biliary communication was found i n 27% of the sample. Patients with abscesses communicating with the bi liary tree presented more frequently with jaundice (67% vs. 0%, P < 0. 005), with a longer duration of illness (median 20 vs. 12 days, P < 0. 001), had larger lesions (median 600 vs. 320 mi, P < 0.001) and requir ed catheter drainage for longer periods (median 17 vs, 6.5 days, P < 0 .000001), However the presence of a biliary communication did not mate rially affect the cure rate with catheter drainage (89% vs 100%, P gre ater than or equal to 0.05), In conclusion, an abscess-biliary communi cation is not uncommon in refractory amebic liver abscesses, and can b e clinically detected by the presence of jaundice. Though a prolonged period of drainage may be necessary in the presence of this complicati on, catheter drainage can be expected to result in cure.