Priyadarshi RN, Kumar R, Anand U. Amebic liver abscess: Clinico-radiological findings and interventional management. World J Radiol 2022; 14(8): 272-285 [PMID: 36160830 DOI: 10.4329/wjr.v14.i8.272]
Corresponding Author of This Article
Ramesh Kumar, MD, Associate Professor, Department of Gastroenterology, All India Institute of Medical Sciences, Patna, Phulwari Sharif, Patna 801507, Bihar, India. docrameshkr@gmail.com
Research Domain of This Article
Radiology, Nuclear Medicine & Medical Imaging
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Rajeev Nayan Priyadarshi, Department of Radiodiagnosis, All India Institute of Medical Sciences, Patna, Patna 801507, Bihar, India
Ramesh Kumar, Department of Gastroenterology, All India Institute of Medical Sciences, Patna, Patna 801507, Bihar, India
Utpal Anand, Department of Surgical Gastroenterology, All India Institute of Medical Sciences, Patna, Patna 801507, Bihar, India
Author contributions: Priyadarshi RN contributed to the concept and design of the manuscript, data collection and manuscript writing; Kumar R and Anand U contributed to the literature search, critical inputs and manuscript revision.
Conflict-of-interest statement: All the authors declare that they have no conflict of interest related to this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ramesh Kumar, MD, Associate Professor, Department of Gastroenterology, All India Institute of Medical Sciences, Patna, Phulwari Sharif, Patna 801507, Bihar, India. docrameshkr@gmail.com
Received: February 28, 2022 Peer-review started: February 28, 2022 First decision: May 9, 2022 Revised: May 30, 2022 Accepted: June 20, 2022 Article in press: June 20, 2022 Published online: August 28, 2022 Processing time: 178 Days and 16.7 Hours
Abstract
In its classic form, amebic liver abscess (ALA) is a mild disease, which responds dramatically to antibiotics and rarely requires drainage. However, the two other forms of the disease, i.e., acute aggressive and chronic indolent usually require drainage. These forms of ALA are frequently reported in endemic areas. The acute aggressive disease is particularly associated with serious complications, such as ruptures, secondary infections, and biliary communications. Laboratory parameters are deranged, with signs of organ failure often present. This form of disease is also associated with a high mortality rate, and early drainage is often required to control the disease severity. In the chronic form, the disease is characterized by low-grade symptoms, mainly pain in the right upper quadrant. Ultrasound and computed tomography (CT) play an important role not only in the diagnosis but also in the assessment of disease severity and identification of the associated complications. Recently, it has been shown that CT imaging morphology can be classified into three patterns, which seem to correlate with the clinical subtypes. Each pattern depicts its own set of distinctive imaging features. In this review, we briefly outline the clinical and imaging features of the three distinct forms of ALA, and discuss the role of percutaneous drainage in the management of ALA.
Core Tip: The clinical presentation and imaging findings of amebic liver abscess (ALA) can be classified into three forms: subacute mild, acute aggressive and chronic indolent. The latter two forms are particularly associated with most complications of ALA. Despite this, prior literature primarily focused on the mild form of the disease, which responds well to antibiotics. To the best of our knowledge, there is no research on the types of ALA. In this review, the distinct clinical and imaging characteristics of each type are discussed in detail. With this understanding, the therapeutic strategy, medical or interventional, can be employed more efficiently for patients with ALA.
