Amebic hepatic abscess in children

• Published in: Journal of pediatric surgery 1995-05, Vol.30 (5), p.662-664
• Main Authors: Porras-Ramírez, Giovanni, Hernández-Herrera, Ma.Helena, Porras-Hernández, Juan D
• Format: Article
• Language: English
• Subjects: Algorithms; Amebicides - therapeutic use; Amibiasis; Biological and medical sciences; Child; Child, Preschool; Emetine - analogs & derivatives; Emetine - therapeutic use; Female; Human protozoal diseases; Humans; Infant; Infectious diseases; Liver Abscess, Amebic - drug therapy; Male; Medical sciences; Metronidazole - therapeutic use; Parasitic diseases; Protozoal diseases; Retrospective Studies; Treatment Outcome; Tropical medicine
• ISSN: 0022-3468; 1531-5037
• DOI: 10.1016/0022-3468(95)90684-3

The authors retrospectively reviewed all case histories of children with amebic hepatic abscess treated from 1975 to 1993 at their hospital. Twenty boys and 12 girls were diagnosed. Their ages ranged from 10 months to 12 years, with a mode of 1 and 2 years. In 17 (53%) of the patients, the abscess remained confined to the liver and was treated medically with dehydroemetine and metronidazole. Imminence of complication was present in 9 patients (52%), and required percutaneous needle aspiration. Imminence of complication was evidenced by: (1) clinical worsening of the patient despite adequate medical treatment, (2) presence of an abscess of 6 cm or more in a spetic patient, or (3) clinical or ultrasonographic findings of an abscess on the verge of rupture. All 9 patients did satisfactorily. Fifteen cases (47%) were complicated by rupture and required surgical treatment. One of these patients died of sepsis. Medical treatment alone was excellent for small abscesses. Percutaneous needle aspiration was a successful approach in patients with imminence of complication. Surgery was reserved for ruptured abscesses.