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Category: Volume 08 Issue 11 November 2020
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Title: A Prospective Study on Diagnosis and Management of Liver Abscess

Authors: Mohamed Fazal A, Anvar Ali A, Ravi Sankar P, Prema M, Prem Kumar T, Brinda Maheswari M

 DOI: https://dx.doi.org/10.18535/jmscr/v8i11.24

Abstract

Background: The abscess of liver is a life threatening disease with majority being amoebic liver abscess in tropical countries like India. The abscesses of liver can be broadly divided into two categories: amoebic and pyogenic. Amoebic liver abscesses (ALA) are the most common extraintestinal site of infection, and occur in fewer than 1% of E histolytica infections [1,2].Treatment modalities grossly changes between abscesses of liver due to amoebic and pyogenic origin and hence the need to differentiate between them early arises. Indirect Haemagglutination test has been an important diagnostic tool in differentiating between liver abscesses of liver due to pyogenic and amoebic origin. Etiopathogenesis of liver abscess due to amoebic origin is different from that of  liver abscess due to pyogenic origin (PLA). Confirmatory diagnosis is indeed important in resource limited settings, as it leads to appropriate management.

Aim and Objectives:

  1. The main aim is to distinguish between liver abscess due to amoebic and pyogenic origin using Indirect Haemagglutination test.
  2. To identify the contrast between clinical presentation of Amoebic and Pyogenic liver abscess with its complications. 

Materials and Methods: A prospective study done during 2018 to 2020 in patients with Clinical/Radiological features of Liver Abscess presenting to RMMCH, Chidambaram with a sample size of 50. Serum obtained from all study subjects and sent for Indirect Haemagglutination test. Pus collected from the abscess cavity sent for culture and sensitivity and their results studied.

Results: From 50 samples studied 33 were diagnosed to have amoebic liver abscess by positive Indirect Haemagglutination  with sterile culture report, 10 patients were diagnosed to have pyogenic liver abscess by isolating organism from pus aspirated from abscess cavity and 7 patients with sterile culture and negative indirect haemagglutination  as indeterminate.

Conclusion: Indirect haemagglutination test of Entamoeba histolytica gives an accurate diagnosis of liver abscess due to amoebic origin. The clinical features and indirect hemagglutination test results helps in achieving accurate diagnosis of amoebic liver abscess.Rapid diagnosis with serology using indirect haemagglutination and initiation of prompt treatment can reduce the hospital stay in the management of amoebic liver abscess

Keywords: Indirect haemaggutination test, liver abscess of amoebic and pyogenic origin.

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Corresponding Author

Dr Anvar Ali A

Professor, Dept of General Surgery, Rajah Muthiah Medical College and Hospital, Annamalai Nagar, Chidambaram, India, 608002