[Amebic abscess of the liver: ultrasound guided puncture].

The aim of this study is to present the results of ultrasound-guided needle aspiration in amoebic abscess of the liver in 1289 patients. Out of 1512 patients hospitalized from 1990 to 1995 for an amoebic abscess of the liver, 1289 (83.6%) were treated by this approach. The abscesses of less than 40 mm (8.9%) were treated medically, and those of more than 170 mm (0.6%) were operated on. The abscesses with peritonitis (5.2%) were also operated on. A treatment with metronidazole or dehydroemetin was associated with the surgical treatment or with the aspiration of the abscess. There was no death. A second aspiration was necessary in 24.9% of the patients, and a third one in 9.4%. Three complications were observed, two hemorrhages and one fistula. Nine patients had a recurrent abscess after their discharge from hospital. Four failures were observed in patients with abscesses of more than 170 mm in diameter. Results were considered as good in 1273 patients (98.7%). These results suggest that in amoebic abscess of the liver with a diameter between 40 and 170 mm, aspiration associated with amoebic treatment may be the standard treatment. Smaller abscesses usually recover with medical treatment alone, and greater abscesses need surgical drainage.