ASPECTS DIAGNOSTIQUES ET THERAPEUTIQUES DES ABCES AMIBIENS DU FOIE DANS LE SERVICE DE CHIRURGIE "A " DU CHU DU POINT "G".

Goal: To evaluate the diagnosis and therapeutic aspects of the amoebic liver abscesses in the surgery« A» department of hospital du Point "G". Patients and methods: Were included in this study, patients admitted to surgery« A » department for amoebic liver abscess on the basis of amoebic serology, chocolate appearance of pus and absence of bacteria in the pus. Bacterial liver abscesses were excluded from this study. Results: Over a period of 10 years, 52 cases of patients diagnosed with amoebic liver abscess were collected in the department. There were 41 men and 11 women, with a sex ratio of 3,7. The medium age of the patients was 37.8 years with extremes of 15 years and 66 years. The most represented occupations were farmers (36.5%) followed by traders (26.7%) and students (11.5%). The average consultation time was 18.5 days (rate 5 days and 34 days). The most frequent clinical signs were pain in the right hypochondrium (86.5%), fever (78.8%) and hepatomegaly (61.5%). Abdominal ultrasound showed a single located abscess in 44 cases (84.6%) and these abscesses were localized in the right hepatic lobe in 34 cases (65.4%). The medium volume of the abscess was 366.5 cm3with the extremes of 36 cm3 and 1580 cm3. Amoebic serology was positive in 80.9%of patients (n = 38). Cytobacteriological analysis of pus in 37 cases (n = 71%) was negative. An ultrasound assisted needle aspiration of pus was performed in 65.4% of patients. The surgical procedure by laparotomy was performed in 7.7% of cases and a laparoscopic approach in 5.8%. The clinical course was uneventfulin 94.2%. The mean hospital stay was 16.5 days with extremes of 4 days and 29 days. No deaths were recorded during hospitalization. Conclusion: Amoebic liver abscess is an uncommon pathology in surgical setting. Abdominal ultrasound and puncture guided by echography allowed the diagnosis. Laparoscopic treatment minimizes the inconvenience of laparotomy. [ABSTRACT FROM AUTHOR]