| Popis: |
Amebic hepatic abscess (AHA) is the most frequent extraintestinal complication of amebiasis. Over time, its treatment has gone through some changes and at present is based on amebicides and in some cases, percutaneous drainage. The objective of this work is to present our experience with percutaneous drainage by means of guided ultrasound in patients with AHA. In this work, we include 170 patients admitted to the Gastroenterology Unit of the Hospital General de Zona No. 1, (IMSS) in Mexico City during a period of eight years (1990-1997). These cases included the following criteria: Failure to medical therapy, AHA of liquid matter greater than 5 cm determined by ultrasound; risk of rupture, prolonged incapacity with no data of toxico-infection, accessible drainage route; availability of operating room before risk of complication, and normal coagulation tests. A modified Seldinger's technique was utilized. A single punction was carried out in 131 patients, who had only one abscess. Thirty-nine patients required a second evacuation on presenting two abscesses, and in four cases, a third evacuation was required due to the presence of three or more abscesses. Only one case required an urgent surgical procedure due to abscess rupture to pleura. Five patients suffered complications, including the latter. The remaining four patients had a spontaneous resolution. All patients were released during the 24 hours following surgery, and no patient required hospitalization. For this reason, this can be considered a procedure that in the expert hands of interventionist radiologists, has less morbidity. This work will be carried out to 10 years. |
