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 .
Long term follow-up of amebic liver abscess: clinical and ultrasound patterns of resolution.
A prospect i ve study was undertaken to evaluate the clinical and sonographic patterns of resolution in amebic liver abscess ( ALA ) . There were 146 patients of ALA attending the gastroenterology clinic of a tertiary care centre of whom 25 died . Of the remaining 121 patients , 107 were followed up for 20.9 + /- 11.4 months . 14 ( 11.3 % ) patients were lost to follow up before complete disappearance of the cavity . Complete disappearance of the cavity was seen in 84 ( 78.5 % ) and a reduction in volume to 50 % at entry in 23 ( 21.5 % ) . Abdominal pain , fever and hepatomegaly were the predominant forms of clinical presentation . On ultrasound , there were 121 cavities in 107 patients . The most frequent type of lesion was solitary , ( 96 % ) round cavity ( 80.4 % ) in the right lobe of liver ( 85 % ) . Clinical and hematological parameters of resolution occurred rapidly ( 3.2 + /- 2.9 months ) . Sonographic resolution took much longer ( 9.6 + /- 6.8 % months ) in the 84 patients . The remaining 23 patients are on follow up . Three pattern of resolution were observed : Type I -- where complete disappearance of the cavity occurred within 3 months ( 29.8 % ) , Type II -- where a gradual reduction and disappearance of the cavity occurred ( 64.3 % ) and Type III -- where a rapid reduction till 25 % of original cavity size remained and then a delayed resolution occurred ( 5.9 % ) . There were no relapses in the patients on follow up . Factors that influenced healing time included the size of the abscess cavity at admission , hypoalbuminemia and anemia . The type of clinical presentation , nature of therapy , number or location of abscesses and time for clinical resolution did not influence the resolution time . None of the variables studied influenced the pattern of resolution . We conclude that rapid clinical resolution is common in patients with ALA . Sonographic resolution may be delayed and does not warrant additional or prolonged therapy
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 .