Demographic, Clinical, Laboratory and Management Profile in Patients of Amoebic Liver Abscess from Northern India

Abstract

Background Amebic liver abscess (ALA) is a serious extraintestinal manifestation of amebiasis and major problem in developing countries. Due to rapid urbanization, improved sanitation and hygiene in India led to shift in disease epidemiology towards non-communicable disease, but recent changes in epidemiological and clinical pattern in ALA are not well studied. So, the present study aimed to evaluate recent demographic, clinical, laboratory and management profile in patient with ALA. Methods It is a prospective observational study conducted in the Department of Gastroenterology, S M S Medical College, Jaipur, Rajasthan from June 2018 to December 2020. A predesigned semi structured questionnaire consisting of sociodemographic factors, risk factors, clinical, laboratory and management profile was used to collect data. Results A total 508 patients of amebic liver abscess were analyzed. Median age of presentation was 40 years, majority were male (90.4%) with chronic alcoholics (47.2%) and belong to lower socioeconomic class. Abdominal pain, fever and anorexia were the commonest symptoms. Majority had right lobe involvement (77.6%) and solitary abscess in 67.5%. Most of small liver abscess (68%) were managed by medical treatment alone. Percutaneous needle aspiration was done in 62.6% patients, mostly for abscess size 5-10 cm (93%) with 90% success. A Total 24.6% patients underwent percutaneous catheter drainage, all successfully done. Intraperitoneal rupture was seen in 10% patient. Mortality was 1.5%. Conclusion There is no difference in sociodemographic, clinical and laboratory profile in the last 2-3 decades. Early initiation of a combined therapeutic approach leads to early symptomatic improvement, fewer complications, and better outcomes.