When is drainage of amebic liver abscess necessary?

Updated: Jul 19, 2019
  • Author: Vinod K Dhawan, MD, FACP, FRCPC, FIDSA; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

Unlike pyogenic liver abscess, uncomplicated amebic liver abscess generally responds to medical therapy alone; drainage is seldom necessary and is usually best avoided. When drainage is necessary, image-guided percutaneous intervention (ie, needle aspiration or catheter drainage [76] ) has replaced surgical intervention as the procedure of choice. The indications for drainage of amebic liver abscess include the following:

  • Presence of a left-lobe abscess more than 10 cm in diameter

  • Impending rupture and abscess that does not respond to medical therapy within 3-5 days

Percutaneous catheter drainage improves treatment outcomes in amebic empyema and is life-saving in amebic pericarditis. It should be used judiciously in the setting of localized intra-abdominal fluid collections.


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