COMPLEX RUPTURED AMEBIC LIVER-ABSCESSES - THE ROLE OF PERCUTANEOUS CATHETER DRAINAGE

The failure of medical therapy for amebic liver abscess may be followe d by its perforation, a complication associated with high mortality. W e assessed the role of percutaneous catheter drainage in management of the sequelae of ruptured amebic abscesses in 13 critically ill patien ts; 22 intrahepatic lesions, three of which were multiloculated, were drained. Catheters were also placed in 17 extrahepatic collections: pl eural space (n = 5), subphrenic (n = 7), perihepatic/subhepatic (n = 3 ), greater sac of peritoneum (n = 2). No attempt at percutaneous drain age failed. Prompt resolution of clinical features following drainage was a uniform feature. Successful resolution of the abscesses occurred within 20 days in 11 patients. In the remaining two, catheters needed to be retained in situ for 35 and 50 days. The mean hospital stay was 15 days (range 10-20 days). 100% patient survival was achieved, witho ut a single morbid episode. Our results suggest that patients with rup tured amebic abscesses can be effectively and safely managed by percut aneous catheter drainage irrespective of the extent of extrahepatic co ntamination.