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Vol. 120 No. 5, May 1985 |
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PAPERS READ BEFORE THE 92ND ANNUAL MEETING OF THE WESTERN SURGICAL ASSOCIATION, COLORADO SPRINGS, COLO, NOV 12-14, 1984-PART I |
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Ruptured Amebic Liver Abscess
Gregory C. Greaney, MD;
Telfer B. Reynolds, MD;
Arthur J. Donovan, MD
Arch Surg. 1985;120(5):555-561.
Abstract
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• Fifteen cases of extrahepatic rupture of amebic liver abscess have been reviewed. Five patients had thoracic rupture and ten had intra-abdominal rupture. Celiotomies were performed in five patients, with a preoperative diagnosis of acute appendicitis with perforation in four patients and generalized peritonitis of unknown origin in one patient. All 15 patients were treated with amebicides, including three patients with documented free intraperitoneal perforation who were not treated surgically. Twelve patients recovered uneventfully. Two patients with thoracic rupture developed secondary bacterial complications and in one case of free intraperitoneal rupture, a mistaken diagnosis of ruptured pyogenic abscess was made. Amebicidal therapy was delayed for four days. The patient died of multisystem organ failure. Amebicidal therapy is effective in the treatment of both unruptured and extrahepatic rupture of amebic liver abscess. Surgery should be required only for secondary bacterial complications.
(Arch Surg 1985;120:555-561)
Author Affiliations
From the Departments of Surgery (Drs Greaney and Donovan) and Medicine (Dr Reynolds), University of Southern California and the Los Angeles County—University of Southern California Medical Center, Los Angeles.
Footnotes
Accepted for publication Feb 14, 1985.
Read before the 92nd annual meeting of the Western Surgical Association, Colorado Springs, Colo, Nov 12, 1984.
Reprint requests to USC Department of Surgery, 1200 N State St, Los Angeles, CA 90033 (Dr Donovan).
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