Amoebic Liver Abscess: Sonographic Patterns And Complications In Enugu, Nigeria

Abstract

This study evaluated the sonographic patterns and complications of amoebic liver abscess (ALA) in Enugu, Nigeria. Request forms, case notes, sonographic reports and images of all patients who had amoebic liver abscess diagnosed at Hansa Clinics Enugu and at the UNTH Enugu within a period of 8 months of 2001 were reviewed. Sonograms obtained were analyzed for size, shape, location, echocharacteristics and complications. Of 3700 abdominal ultra sound examinations done, 62 (1.7%) cases of ALA were identified during the review period. Of these, 5(8%) were females and 57(92%) males. Their ages ranged between 19 and 78 years. The echopatterns encountered in 86 abscess cavities, were echorich in 48 abscesses (58%); echopoor and anechoic in 13 (17. 4%) and mixed or inhomogenously hypoechoic in 25 (29.6%) of the abscesses. 18 patients had 21 ALA complications sonographically. These were 3 jaundice, 3 Ascitis, 2 subhepatic effusion, 1 heterotopic splenic abscess, 1 extraperitioneal rupture, 1 intraperitioneal rupture, 3 subphrenic abscess and 7 pleuropulmonary complications. Untreated complicated hepatic amoebic abscesses are associated with high
morbidity and mortality and should receive urgent medical intervention. Sonography remains a veritable tool in the timely investigation of right upper quadrant abdominal pain especially in areas of endemic amoebiasis. Its application would reduce morbidity and mortality of ALA.