1/2. Syndromes in amoebic liver abscess.A series of 137 patients with amoebic liver abscess has been studied. Recognition of clearly defined but diverse clinical syndromes was found to be necessary not only in diagnosis but also in planned surgical management. The majority of patients had the classic syndrome of fever, right abdominal or chest pain, hepatomegaly, hepatic tenderness and radiological abnormalities. Other syndromes of presentation included the silent abscess, acute amoebic colitis, the acute abdomen, the intraabdominal lump, the external sinus, pyrexia of obscure origin, obstructive jaundice and renal, pleuro-pulmonary and cardiac symptoms. The syndromes due to an abscess in different parts of the right lobe and in the left lobe of the liver are to some extent distinct. In spite of the varied modes of presentation of amoebic liver abscess, the key to diagnosis is an understanding of the chronological sequence of the disease and its progression from one syndrome to another. Diagnostic methods of value and the mortality are discussed.- - - - - - - - - - ranking = 1keywords = sinus (Clic here for more details about this article) |
2/2. Unruptured amoebic liver abscess presenting as acute abdomen.Unruptured amoebic liver abscess is usually not regarded as a surgical emergency. At University College Hospital, Ibadan, in a two-year period from June 1975 to May 1977, six cases of unruptured amoebic liver abscess underwent emergency exploratory laparotomy because they presented as cases of acute abdomen. The initial diagnoses made by senior physicians included perforated duodenal ulcer, intestinal obstruction, cholecystitis and appendicitis. All patients had persistent draining sinuses after surgery for periods ranging from one to five months. Neither the trophozoites nor the cystic forms of entamoeba histolytica were present in the "abscess" which was essentially necrotic liver tissue. The diagnosis of amoebic liver abscess was based on clinical features: typical "anchovy" or chocolate-coloured aspirate from the liver, response to anti-amoebic therapy and serological studies.- - - - - - - - - - ranking = 1keywords = sinus (Clic here for more details about this article) |