The indications for drainage of liver abscess together with medical management are: (1) left lobe liver abscess, (2) abscess with thin rim of hepatic parenchyma (10 cm), subcapsular location, high risk for rupture, and if superinfected. The clinical course of ALA is usually benign in the absence of poor prognostic markers (Table (Table2 2). Recognizing the unusual variants of ALA is important because these are generally associated with complications (Table (Table1 1). Jaundice can be seen in about 15% of patients with ALA and is usually associated with a large and/or multiple abscesses and compression of biliary tree by an abscess near porta hepatis or caused by concomitant alcoholic hepatitis.Īlthough classically described as a solitary abscess in the right lobe of the liver, 35% of patients may have a left lobe liver abscess with or without a right lobe abscess, and 15% of patients can have multiple liver abscesses. The clinical presenting features include fever, pain in the abdomen, and anorexia. Risk factors include chronic alcohol use, diabetes, cirrhosis, and retroviral disease. The disease usually occurs in male patients in the 20 to 45 years age group. ALA is the most common extraintestinal involvement in amoebiasis, seen in 3% to 9% of cases. Amoebiasis is endemic in India and primarily affects the gastrointestinal tract.
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