There was no significant difference in relation to the resolution of fever , abscess size , and hospital stay .
The beneficial effects of PA were seen with medium-to-large ( > 5 cm ) ALA and not with small ( < 5 cm ) ALA .
Percutaneous aspiration as compared with metronidazole alone results in the early resolution of pain and tenderness in patients with medium-to-large ALA .
Percutaneous catheter drainage is better for larger ALA .
The role of metronidazole alone , percutaneous aspiration ( PA ) , and percutaneous catheter drainage ( PCD ) in the treatment of uncomplicated amebic liver abscess ( ALA ) is still unclear .
This systematic review and meta- analysis evaluated the available evidence s with regard to treatment modalities in such patients .
Needle aspiration in large amoebic liver abscess.
The role of percutaneous needle aspiration for therapy of uncomplicated , large amoebic liver abscess ( ALA ) is not defined . Twenty nine patients of ALA with a cavity larger than 5 cm were r and omised to two groups : ( i ) metronidazole 800 mg tid for 10 days combined with needle aspiration ( group A , n = 15 ) and ( ii ) metronidazole therapy alone ( group B , n = 14 ) . Clinical parameters , viz , fever , pain and abdominal tenderness were recorded daily and grade d 0 to 3 ( in order of increasing severity ) . A statistically significant benefit was demonstrated in group A for clinical parameters evaluated . Group A patients took less time to become afebrile from the grade 2 level as compared to group B ( 3.8 + /- 1.7 days and 5.6 + /- 2.2 days respectively ; p < 0.05 ) . Reduction in pain intensity and abdominal tenderness from grade 2 to 1 also occurred earlier in group A ( 0.7 + /- 0.7 days vs 2.9 + /- 0.9 days for pain , P < 0.001 and 1.7 + /- 0.8 days vs 2.9 + /- 1.2 days for abdominal tenderness , p < 0.001 ) . The mean duration of hospitalization was significantly shorter in group A as compared to group B ( 5.8 + /- 0.8 days vs 7.4 + /- 1.5 days , p < 0.001 ) . Improvement in haematological and biochemical variables was similar in both groups . We conclude that percutaneous therapeutic needle aspiration of uncomplicated , large ALA hastens clinical recovery
There was no significant difference in relation to the resolution of fever , abscess size , and hospital stay .
The beneficial effects of PA were seen with medium-to-large ( > 5 cm ) ALA and not with small ( < 5 cm ) ALA .
Percutaneous aspiration as compared with metronidazole alone results in the early resolution of pain and tenderness in patients with medium-to-large ALA .
Percutaneous catheter drainage is better for larger ALA .
The role of metronidazole alone , percutaneous aspiration ( PA ) , and percutaneous catheter drainage ( PCD ) in the treatment of uncomplicated amebic liver abscess ( ALA ) is still unclear .
This systematic review and meta- analysis evaluated the available evidence s with regard to treatment modalities in such patients .