Needle aspiration of amoebic liver abscess

Abstract

OBJECTIVE–To determine the value of needle aspiration in uncomplicated amoebic liver abscess. DESIGN–Randomised case-control study with a minimum follow up of one year, comparing patients treated with drugs alone with those treated with additional needle aspiration. SETTING–Referral based gastroenterology clinic. PATIENTS–39 Consecutive patients with amoebic liver abscess in the right lobe, of whom 37 completed the study. INTERVENTION–Metronidazole 2.4 g/day was given to all patients for 10 days. Needle aspiration of the abscess was performed in 19 patients on the day of admission to hospital. MAIN OUTCOME MEASURES–Abdominal pain, fever, anorexia, and hepatomegaly were measured. Erythrocyte sedimentation rate, serum aspartate, and alanine aminotransferase activities, and alkaline phosphatase activity were also measured. RESULTS–Clinical improvement was similar in both groups of patients. Improvement in haematological and biochemical variables and rates of healing of cavities were also similar. CONCLUSIONS–Chemotherapy with potent tissue amoebicidal drugs such as metronidazole is optimally effective in treating amoebic liver abscess, and in uncomplicated cases routine aspiration is not required.