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      Amebic liver abscess: Clinico-radiological findings and interventional management

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          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.

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          Most cited references97

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          Amoebiasis.

          Amoebiasis is the second leading cause of death from parasitic disease worldwide. The causative protozoan parasite, Entamoeba histolytica, is a potent pathogen. Secreting proteinases that dissolve host tissues, killing host cells on contact, and engulfing red blood cells, E histolytica trophozoites invade the intestinal mucosa, causing amoebic colitis. In some cases amoebas breach the mucosal barrier and travel through the portal circulation to the liver, where they cause abscesses consisting of a few E histolytica trophozoites surrounding dead and dying hepatocytes and liquefied cellular debris. Amoebic liver abscesses grow inexorably and, at one time, were almost always fatal, but now even large abscesses can be cured by one dose of antibiotic. Evidence that what we thought was a single species based on morphology is, in fact, two genetically distinct species--now termed Entamoeba histolytica (the pathogen) and Entamoeba dispar (a commensal)--has turned conventional wisdom about the epidemiology and diagnosis of amoebiasis upside down. New models of disease have linked E histolytica induction of intestinal inflammation and hepatocyte programmed cell death to the pathogenesis of amoebic colitis and amoebic liver abscess.
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            Amebiasis.

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              Problems in recognition and diagnosis of amebiasis: estimation of the global magnitude of morbidity and mortality.

              J A Walsh (2015)
              Major problems with a wide array of imperfect tests for diagnosis of amebiasis severely limit the understanding of its magnitude and epidemiology. A greater hindrance is the varied, inconsistent application of existing methods in different areas of the world. The best estimates suggest that probably 480 million people were infected with Entamoeba histolytica and 36 million developed disabling colitis or extraintestinal abscesses in 1981. At least 40 thousand deaths are attributable to amebiasis, and on a global scale, amebiasis likely ranks third among parasitic causes of death, behind only malaria and schistosomiasis. Much remains to be learned of its frequency of occurrence and epidemiology as needed improved diagnostic tools are developed.
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                Author and article information

                Contributors
                Journal
                World J Radiol
                WJR
                World Journal of Radiology
                Baishideng Publishing Group Inc
                1949-8470
                28 August 2022
                28 August 2022
                : 14
                : 8
                : 272-285
                Affiliations
                Department of Radiodiagnosis, All India Institute of Medical Sciences, Patna, Patna 801507, Bihar, India
                Department of Gastroenterology, All India Institute of Medical Sciences, Patna, Patna 801507, Bihar, India. docrameshkr@ 123456gmail.com
                Department of Surgical Gastroenterology, All India Institute of Medical Sciences, Patna, Patna 801507, Bihar, India
                Author notes

                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.

                Corresponding author: Ramesh Kumar, MD, Associate Professor, Department of Gastroenterology, All India Institute of Medical Sciences, Patna, Phulwari Sharif, Patna 801507, Bihar, India. docrameshkr@ 123456gmail.com

                Article
                jWJR.v14.i8.pg272
                10.4329/wjr.v14.i8.272
                9453321
                36160830
                2589b14e-621b-44e4-8654-9a8659401eef
                ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.

                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/

                History
                : 28 February 2022
                : 30 May 2022
                : 20 June 2022
                Categories
                Minireviews

                amebic liver abscess,complicated liver abscess,refractory liver abscess,ruptured amebic liver abscess,pleuropulmonary complication,biliary communication,needle aspiration,catheter drainage

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