Baijal S S, Agarwal D K, Roy S, Choudhuri G
Department of Radiodiagnosis, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India.
Eur J Radiol. 1995 May;20(1):65-7. doi: 10.1016/0720-048x(95)00613-u.
The failure of medical therapy for amebic liver abscess may be followed by its perforation, a complication associated with high mortality. We assessed the role of percutaneous catheter drainage in management of the sequelae of ruptured amebic abscesses in 13 critically ill patients; 22 intrahepatic lesions, three of which were multiloculated, were drained. Catheters were also placed in 17 extrahepatic collections: pleural space (n = 5), subphrenic (n = 7), perihepatic/subhepatic (n = 3), greater sac of peritoneum (n = 2). No attempt at percutaneous drainage failed. Prompt resolution of clinical features following drainage was a uniform feature. Successful resolution of the abscesses occurred within 20 days in 11 patients. In the remaining two, catheters needed to be retained in situ for 35 and 50 days. The mean hospital stay was 15 days (range 10-20 days). 100% patient survival was achieved, without a single morbid episode. Our results suggest that patients with ruptured amebic abscesses can be effectively and safely managed by percutaneous catheter drainage irrespective of the extent of extrahepatic contamination.
阿米巴肝脓肿内科治疗失败后可能会发生穿孔，这是一种死亡率很高的并发症。我们评估了经皮导管引流在13例危重症患者破裂性阿米巴脓肿后遗症管理中的作用；对22个肝内病变进行了引流，其中3个为多房性。还对17个肝外积液放置了导管：胸腔（n = 5）、膈下（n = 7）、肝周/肝下（n = 3）、腹膜大囊（n = 2）。经皮引流无一失败。引流后临床症状迅速缓解是一致的表现。11例患者的脓肿在20天内成功消退。其余2例患者的导管需要分别原位保留35天和50天。平均住院时间为15天（范围10 - 20天）。患者生存率达100%，无任何并发症发生。我们的结果表明，无论肝外感染程度如何，破裂性阿米巴脓肿患者均可通过经皮导管引流得到有效且安全的治疗。
