Amoebic liver abscess most commonly affects -
Right lobe of liver
Left lobe of liver
Portal vein
Right pleural cavity
Ans. is 'a' i.e., Right lobe of liver Amoebic Liver abscesso Caused by Entamoeba histolytica whose cysts are acquired through the feco-oral route and their trophozoites reach the liver through portal venous systemo Like pyogenic abscess they are also common in rt. lobe of livero Clinical Picture# the typical clinical picture is of a patient 20-40 yrs of age who has travelled to an endemic area, presents with fever, chills, anorexia, rt. upper quadrant pain.# although liver abscess results from an obligatory colonic infection, a recent history of diarrhoea is uncommon.# jaundice is rare. (c.f. in pyogenic abscess jaundice is seen in -25% of pts.)o Liver function tests may show mild abnormalities, hyperbilirubinemia is uncommono CT > U/S are the mainstay of investigation.o Diagnosis is confirmed by serological tests (enzyme immuno assay) for antiamoebic antibodieso Cultures of amoebic abscess are usually negativeo Treatment# Metronidazole is the mainstay of t/t and is curative in over 90% of patients.(other nitroimidazoles i.e. secnidazole, tinidazole, are also effective)#Therapeutic needle aspiration is avoided. Done only wheno pt. fails to respond to metronidazoleo high risk of ruptureo abscess secondarily infected with pyogenic organismo Complications may occur uncommonly; these are# rupture into the peritoneum, pleural cavity or pericardium.
Hepatic Tumors, Cysts, and Abscesses