AMOEBIC LIVER ABSCESS; CAN ULTRASOUND BE HELPFUL IN EARLY DETECTION AND CHARACTERIZATION IN HIGH-RISK POPULATION?

Abstract

Amoebic liver abscess (ALA) is the most common manifestation of extra-intestinal amebiasis. It’s one of the most common causes in developing world like Pakistan due to poor hygiene and sanitation conditions. Clinical symptoms for diagnosis of ALA are sensitive but not very specific therefore pathological confirmation is required which is invasive. Ultrasound can be a useful non-invasive technique to diagnose ALA and appears to be cost effective and safe.   This study was focused on determining diagnostic accuracy of ultrasound in detection of amoebic liver abscess by taking histopathology as gold standard.

Methods: cross-sectional study performed from 22-01-2019 to 21-07-2019. 105 cases undergoing liver abscess aspiration were included in the study. Ultrasound was performed by a Sonologist/Radiologist with a minimum of 5 years’ experience of abdominal sonography. Patient demographics and Sonographic features were recorded on a Proforma.

Results: Mean age of the patients was 49.3±17.5, males 74 (70.5%) females 31 (29.5%). Single lesions found in 98 patients (93.3%) and multiple lesions in 7 patients (6.7%), in 93 (88.6%) the location of lesion was right and in 12 patients (11.4%) location of lesion was left. Ultrasound showed sensitivity 97.5%, specificity 82.6%, PPV 95.2%, NPV 90.4% and diagnostic accuracy 94.2%, in detection of amoebic liver abscess.

Conclusion: ultrasonography is highly sensitive, safe and non-invasive modality for diagnosing amoebic liver abscess. It can also be used for location of the ALA, estimation of size and volume, as well as evaluation of complications.

KEY WORDS:

Amoebic liver abscess, Ultrasound