All of the following is true about amoebic liver abscess except –
Correct Answer: It is common in the left lobe of the liver
Description: Amoebic Liver abscess Caused by Entamoeba histolytica whose cysts are acquired through the feco-oral route and their trophozoites reach the liver through poal venous system Like pyogenic abscess they are also common in . lobe of liver Clinical Picture The typical clinical picture is of a patient 20-40 yrs of age who has travelled to an endemic area, presents with fever, chills, anorexia, . upper quadrant pain. Although liver abscess results from an obligatory colonic infection, a recent history of diarrhoea is uncommon. Jaundice is rare. (c.f. in pyogenic abscess jaundice is seen in -25% of pts.) Liver function tests may show mild abnormalities, hyperbilirubinemia is uncommon CT > U/S are the mainstay of investigation. Diagnosis is confirmed by serological tests (enzyme immuno assay) for antiamoebic antibodies Cultures of amoebic abscess are usually negative Treatment Metronidazole is the mainstay of t/t and is curative in over 90% of patients, (other nitroimidazoles i.e. secnidazole, tinidazole, are also effective) Therapeutic needle aspiration is avoided. Done only when Pt. fails to respond to metronidazole High risk of rupture Abscess secondarily infected with pyogenic organism Complications may occur uncommonly; these are Rupture into the peritoneum, pleural cavity or pericardium Ref srb manual of surgery 5e Liver p596
Category:
Anatomy
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