Demographic, Clinical, Laboratory and Management Profile in Patients of Amoebic Liver Abscess from Northern India
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Date
2022-03
Journal Title
Journal ISSN
Volume Title
Publisher
All India Institute of Medical Sciences
Abstract
Background: Amoebic liver abscess (ALA) is a serious extra-intestinal manifestation of amoebiasis and a major problem in developing countries. Due to rapid urbanization, improved sanitation and hygiene in India, there has been a shift in disease epidemiology towards non-communicable disease, but recent changes in epidemiological and clinical pattern in ALA are not well studied. Aim: To evaluate recent demographic, clinical, laboratory and management profile in patient with ALA. Methods: It is a prospective observational study conducted in the Department of Gastroenterology, SMS medical college, Jaipur, Rajasthan from June 2018 to December 2020. A predesigned semi structured questionnaire consisting of socio-demographic factors, risk factors, clinical, laboratory and management profile was used to collect data. Result: A total 508 patients of amoebic liver abscess were analysed. Median age of presentation was 40 years, majority were males (90.4%) with chronic alcoholism (44.1%) and belonging to lower socio-economic class. Abdominal pain, fever and anorexia were the most common symptoms. A majority had right lobe involvement (77.6%) and solitary abscess in 67.5%. Most of the small liver abscesses (68%) were managed by medical treatment alone. Percutaneous needle aspiration was done in 62.6% patients, mostly for abscess size 5-10 cm (93%) with 90% success. A total of 24.6% patients underwent percutaneous catheter drainage, all successfully done. Intraperitoneal rupture was seen in 10% patient. Mortality was 1.5%. Conclusion: This is one of the largest cohorts of ALA which shows that a majority of cases are males from lower socioeconomic status with history of significant alcohol intake. Early initiation of a combined therapeutic approach leads to early symptomatic improvement, fewer complications and better outcomes.
Description
Keywords
Amoebiasis, Amoebic Liver Abscess, Non-communicable Disease, Percutaneous Needle Aspiration, Percutaneous Catheter Drainage.
Citation
Dhaked GK, Agarwal VK, Dhaked S, Ahmad T, Jhajharia A, Ashdhir P, Pokharna RK. Demographic, Clinical, Laboratory and Management Profile in Patients of Amoebic Liver Abscess from Northern India. Tropical Gastroenterology. 2022 Mar; 43(1): 16-21