Amoebic Liver Abscesses in Fiji: Epidemiology, Clinical Presentation and Comparison of Percutaneous Aspiration and Percutaneous Catheter Drainage

Background Amoebic liver abscess (ALA) is a common clinical problem in tropical countries related to poor sanitation. The epidemiology and clinical presentation of ALA in Fiji has not been previously described. It is unclear whether percutaneous aspiration (PA) or percutaneous catheter drainage (PCD...

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Bibliographic Details
Published in:World journal of surgery 2020-03, Vol.44 (3), p.665-672
Main Authors: Vakamacawai, Esala, McCaig, Eddie, Waqainabete, Ifereimi, Cox, Michael R.
Format: Article
Language:English
Subjects:
Abdominal Surgery
Abscesses
Adult
Bile
Bleeding
Cardiac Surgery
Catheters
Complications
Drainage - methods
Epidemiology
Female
Fever
General Surgery
Humans
Liver
Liver Abscess, Amebic - epidemiology
Liver Abscess, Amebic - surgery
Male
Males
Medical instruments
Medical treatment
Medicine
Medicine & Public Health
Middle Aged
Minority & ethnic groups
Morbidity
Pain
Patients
Retrospective Studies
Sanitation
Surgery
Surgery in Low and Middle Income Countries
Thoracic Surgery
Vascular Surgery
Wound drainage
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Summary:Background Amoebic liver abscess (ALA) is a common clinical problem in tropical countries related to poor sanitation. The epidemiology and clinical presentation of ALA in Fiji has not been previously described. It is unclear whether percutaneous aspiration (PA) or percutaneous catheter drainage (PCD) has better outcomes. Purpose The aims were to describe the epidemiology and clinical presentation of ALA in Fiji and to compare the outcomes of PA and PCD for treatment of ALA. Methods A retrospective case note review of patients treated with either PA or PCD between 2010 and 2015 was performed. Indications for intervention were ALA > 5 cm, ALA in the left lateral lobe, risk of imminent rupture and failure to respond to medical treatment. Results There were 262 patients, 90% were male, 92.9% I-Taukei ethnicity and 86.2% regular recreational kava drinkers. Most presented with upper abdominal pain and fevers. The majority (90.3%) had a single abscess with 87.8% being in the right lobe. 174 (66.4%) had LA and 88 (33.6%) had PCD. There was an unintended selection bias for PA in abscess with a volume of
ISSN:0364-2313
1432-2323
DOI:10.1007/s00268-019-05274-7