Sonographically guided percutaneous catheter drainage versus needle aspiration in the management of amebic liver abscess at the Zamboanga City Medical Center from 2011 to 2014.

OBJECTIVES: To compare per cutaneous catheter drainage (PCD) with per cutaneous needle aspiration (PNA) in the management of amoebic liver abscess (ALA) as well as to compare clinical outcomes i terms of therapeutic eficacy while presenting the clinical profile and characteristics of the disease.

METHODOLOGY: This is an unmatched retrospective cohort design. Frequencies and percentages to determining the clinical profile, characteristics f ALA and risk factors of patients diagnosed to have ALA are used in data analysis. Patient record are retrieved and reviewed at the medical record section o our institution. The determination of clinical data based on history, physical examination, ultrasonographic and laboratory findings associated with ALA. The effectiveness of either treatment is measured in terms of clinical improvement, 50% reduction in abscess cavity size or total resolution of abscess cavity.

RESULTS:  A total of 115 patients are diagnosed with ALA from 2011 to 2014 at our institution. Sixty-two patients with ALA met the inclusion criteria and were included in the study. The PCD group consisted of 32 patients who are treated by ultrasound-guided PCD. The other 30 patients are treated with PNA. Those who lacked response (clinical improvement, 50% reduction in abscess cavity size or total resolution of abscess cavity) after the third aspiration is considered treatment failure. Patients with treatment failure under PNA are treated with PCD but are not included in the PCD group for analysis. Percutaneous Needle Aspiration is successful in 20 (67%) of the 30 patients after one (n=15), two (n=4), or three (n=1) aspirations. Percutaneous Catheter Drainage is successful in all 32 patient after one (n=31) or two (n=1) procedures. None of patients in the PNA group with multi-loculated abscesses (n=5) are successfully treated.

CONCLUSION: Percutaneous catheter drainage is more effective than PNA in the management of ALA. Percutaneous catheter drainage is more effective for ALA with multiloculated septation.

RECOMMENDATION: A prospective randomized controlled study should be conceptualized to be able to come up with a standardized protocol to be followed in dealing with ALA.