Abstract：
BACKGROUND: Amoebic liver abscess (ALA) is the fourth cause of mortality by parasitic infection. This study aimed to assess clinical, radiological and therapeutic characteristics of patients admitted for amoebic liver abscess compared to pyogenic abscess in a French digestive tertiary care-centre.
METHODS: The charts of patients hospitalized for a liver abscess between 2010 and 2020 were retrospectively assessed then separated in two groups: amoebic liver abscess and pyogenic liver abscess from portal underlying cause. Clinical and radiological data were collected for univariate comparison.
RESULTS: Twenty-one patients were hospitalized during the time of the study for ALA, and 21 patients for pyogenic liver abscess with a portal mechanism. All patients hospitalized for ALA lived in and/or had travelled recently in an endemic area. In comparison with patients hospitalized for pyogenic abscess, patients admitted for ALA were younger (44years old vs. 63years old, P<0.001), had less comorbidities (5% vs. 43% of patients with at least one comorbidity, P<0.01), a longer median duration of symptoms (10days vs. 3days, P=0.015), abdominal pain (86% vs. 52%, P=0.019), and a slighter leucocytosis (9600G/L vs. 15,500G/L, P=0.041) were more frequent. On the abdominal tomodensitometry, density of ALA was higher (34 vs. 25 UH, P<0.01), associated with a focal intra-hepatic biliary dilatation and less often multiloculated.
CONCLUSIONS: While rare in western countries, amoebic liver abscess care should not be underestimated. The presence of a solitary liver abscess of intermediate density on computed tomography, occurring on a patient returning from an endemic zone should lead the physician to a possible diagnosis of ALA.
METHODS: The charts of patients hospitalized for a liver abscess between 2010 and 2020 were retrospectively assessed then separated in two groups: amoebic liver abscess and pyogenic liver abscess from portal underlying cause. Clinical and radiological data were collected for univariate comparison.
RESULTS: Twenty-one patients were hospitalized during the time of the study for ALA, and 21 patients for pyogenic liver abscess with a portal mechanism. All patients hospitalized for ALA lived in and/or had travelled recently in an endemic area. In comparison with patients hospitalized for pyogenic abscess, patients admitted for ALA were younger (44years old vs. 63years old, P<0.001), had less comorbidities (5% vs. 43% of patients with at least one comorbidity, P<0.01), a longer median duration of symptoms (10days vs. 3days, P=0.015), abdominal pain (86% vs. 52%, P=0.019), and a slighter leucocytosis (9600G/L vs. 15,500G/L, P=0.041) were more frequent. On the abdominal tomodensitometry, density of ALA was higher (34 vs. 25 UH, P<0.01), associated with a focal intra-hepatic biliary dilatation and less often multiloculated.
CONCLUSIONS: While rare in western countries, amoebic liver abscess care should not be underestimated. The presence of a solitary liver abscess of intermediate density on computed tomography, occurring on a patient returning from an endemic zone should lead the physician to a possible diagnosis of ALA.
摘要：
背景：阿米巴肝脓肿（ALA）是寄生虫感染导致死亡的第四大原因。本研究旨在评估临床，与法国三级消化护理中心的化脓性脓肿相比，因阿米巴肝脓肿入院的患者的放射学和治疗特征。
方法：回顾性评估了2010年至2020年因肝脓肿住院的患者的图表，然后将其分为两组：阿米巴肝脓肿和化脓性肝脓肿与门静脉潜在原因。收集临床和放射学数据用于单变量比较。
结果：21名患者在ALA研究期间住院，21例具有门静脉机制的化脓性肝脓肿患者。所有因ALA住院的患者都居住在流行地区和/或最近旅行过。与因化脓性脓肿住院的患者相比，因ALA入院的患者较年轻(44岁vs.63岁,P<0.001)，合并症较少(5%vs.43％的患者至少有一种合并症，P<0.01),症状的中位持续时间更长(10天vs.3天,P=0.015),腹痛（86%vs.52%,P=0.019),和轻微的白细胞增多（9600G/Lvs.15,500G/L,P=0.041）更频繁。在腹部断层密度测定中，ALA的密度更高(34vs.25UH,P<0.01),与局灶性肝内胆管扩张和较少的多部位有关。
结论：虽然在西方国家很少见，阿米巴肝脓肿的护理不可低估。在计算机断层扫描中存在中等密度的孤立性肝脓肿，发生在从流行区返回的患者身上,应引导医师做出可能的ALA诊断.
方法：回顾性评估了2010年至2020年因肝脓肿住院的患者的图表，然后将其分为两组：阿米巴肝脓肿和化脓性肝脓肿与门静脉潜在原因。收集临床和放射学数据用于单变量比较。
结果：21名患者在ALA研究期间住院，21例具有门静脉机制的化脓性肝脓肿患者。所有因ALA住院的患者都居住在流行地区和/或最近旅行过。与因化脓性脓肿住院的患者相比，因ALA入院的患者较年轻(44岁vs.63岁,P<0.001)，合并症较少(5%vs.43％的患者至少有一种合并症，P<0.01),症状的中位持续时间更长(10天vs.3天,P=0.015),腹痛（86%vs.52%,P=0.019),和轻微的白细胞增多（9600G/Lvs.15,500G/L,P=0.041）更频繁。在腹部断层密度测定中，ALA的密度更高(34vs.25UH,P<0.01),与局灶性肝内胆管扩张和较少的多部位有关。
结论：虽然在西方国家很少见，阿米巴肝脓肿的护理不可低估。在计算机断层扫描中存在中等密度的孤立性肝脓肿，发生在从流行区返回的患者身上,应引导医师做出可能的ALA诊断.
