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.
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.