خراج الكبد الأميبي غير المعقد: ماذا تفعل عندما يفشل العلاج الدوائي الأولي في تحسين الأعراض خلال 72 ساعة

DOI: 10.4254/wjh.v16.i3.316

• For uncomplicated amebic liver abscess (ALA): Upfront percutaneous drainage (PD) should be considered only in the presence of high risk signs; PD doesn't provide added benefit when ALA size is < 5 cm, and ALA with size > 5 should be treated initially with medical therapy (MT) consisting of anti-amebic drug for 3-5 d before considering PD in case of non-response.
• Thus, a conservative strategy should be adopted for most patients with uncomplicated ALA.
• Therefore, percutaneous drainage should be considered for patients who fail to respond within 3 to 5 d of medical therapy.
• For PD, a percutaneous catheter drainage (PCD) is preferred over needle aspiration, particularly for larger and incompletely liquified ALA.
• However, PNA may be considered for draining completely liquefied multiple smaller abscesses.