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Endoscopic ultrasound-guided drainage of an amoebic liver abscess extending into the hepatic subcapsular space

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Abstract

Here, we report a case of an amoebic liver abscess (ALA) successfully treated with endoscopic ultrasound (EUS)-guided liver abscess drainage (EUS-LAD). A 37-year-old male with a liver abscess was referred to our hospital due to disease progression despite receiving antibiotic therapy. Computed tomography showed an intrahepatic abscess extending into the hepatic subcapsular space. The abscess could not be punctured through the hepatic parenchyma percutaneously due to the presence of hepatic subcapsular lesions. Hence, EUS-LAD was performed via the transhepatic approach through the stomach. A 5-Fr pigtail-type nasocystic tube was inserted into the abscess through the hepatic parenchyma, with no procedure-related complications. The contents of the abscess had the appearance of anchovy paste which made us suspect an amoebic abscess; therefore, we started antibiotic therapy with metronidazole. Afterwards, serum anti-amoebic antibodies were found to be positive and the diagnosis of ALA was confirmed. Two weeks later, the size of the abscess decreased, and the patient’s clinical symptoms disappeared. Hence, the tube was removed. There were no signs of recurrence during the follow-up period. The use of EUS-LAD for pyogenic or tuberculous abscesses has been reported previously. EUS-LAD for an ALA, similar to that for other liver abscesses, is an effective alternative to percutaneous transhepatic abscess drainage or surgical treatment.

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References

  1. Wells CD, Arguedas M. Amebic liver abscess. South Med J. 2004;97:673–82.

    Article  PubMed  Google Scholar 

  2. Weinke T, Grobusch MP, Güthoff W. Amebic liver abscess–rare need for percutaneous treatment modalities. Eur J Med Res. 2002;29:25–9.

    Google Scholar 

  3. Seewald S, Imazu H, Omar S, et al. EUS-guided drainage of hepatic abscess. Gastrointest Endosc. 2005;61:495–8.

    Article  PubMed  Google Scholar 

  4. Ang TL, Seewald S, Teo EK, et al. EUS-guided drainage of ruptured liver abscess. Endoscopy. 2009;41(Suppl 2):E21–2.

    Article  PubMed  Google Scholar 

  5. Noh SH, do Park H, Kim YR, et al. EUS-guided drainage of hepatic abscesses not accessible to percutaneous drainage. Gastrointest Endosc. 2010;71:1314–9.

    Article  PubMed  Google Scholar 

  6. Itoi T, Ang TL, Seewald S, et al. Endoscopic ultrasonography-guided drainage for tuberculous liver abscess drainage. Dig Endosc. 2011;23(Suppl 1):158–61.

    Article  PubMed  Google Scholar 

  7. Alcaide N, Vargas-Garcia AL, de la Serna-Higuera C, et al. EUS-guided drainage of liver abscess by using a lumen-apposing metal stent (with video). Gastrointest Endosc. 2013;78:941–2.

    Article  PubMed  Google Scholar 

  8. Kawakami H, Kawakubo K, Kuwatani M, et al. Endoscopic ultrasonography-guided liver abscess drainage using a dedicated, wide, fully covered self-expandable metallic stent with flared-ends. Endoscopy. 2014;46(S 01):E982–3.

    Article  PubMed  Google Scholar 

  9. Singhal S, Changela K, Lane D, et al. Endoscopic ultrasound-guided hepatic and perihepatic abscess drainage: an evolving technique. Therap Adv Gastroenterol. 2014;7:93–8.

    Article  PubMed Central  PubMed  Google Scholar 

  10. Petri WA Jr, Singh U. Diagnosis and management of amebiasis. Clin Infect Dis. 1999;29:1117–25.

    Article  PubMed  Google Scholar 

  11. Shelton AA. Sexually transmitted parasitic diseases. Clin Colon Rectal Surg. 2004;17:231–4.

    Article  PubMed Central  PubMed  Google Scholar 

  12. Salit IE, Khairnar K, Gough K, et al. A possible cluster of sexually transmitted Entamoeba histolytica: genetic analysis of a highly virulent strain. Clin Infect Dis. 2009;49:346–53.

    Article  CAS  PubMed  Google Scholar 

  13. Wuerz T, Kane JB, Boggild AK, et al. A review of amoebic liver abscess for clinicians in a nonendemic setting. Can J Gastroenterol. 2012;26:729–33.

    PubMed Central  PubMed  Google Scholar 

  14. Amarapurkar DN, Patel N, Amarapurkar AD. Amoebic liver abscess. J Hepatol. 2003;39:291–2.

    Article  CAS  PubMed  Google Scholar 

  15. Memon AS, Siddiqui FG, Memon HA, et al. Management of ruptured amoebic liver abscess: 22-years experience. J Ayub Med Coll Abbottabad. 2010;22:96–9.

    CAS  Google Scholar 

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Authors and Affiliations

  1. Gastroenterology Medicine Center, Shonan Kamakura General Hospital, 1370-1 Okamoto, Kamakura, Kanagawa, 247-8533, Japan

    Kazuya Koizumi, Sakue Masuda, Haruki Uojima, Chikamasa Ichita, Shinnosuke Tokoro, Akiko Sasaki, Hideto Egashira, Takeshi Kimbara & Makoto Kako

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  1. Kazuya Koizumi
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  2. Sakue Masuda
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  3. Haruki Uojima
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  4. Chikamasa Ichita
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  5. Shinnosuke Tokoro
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  6. Akiko Sasaki
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  7. Hideto Egashira
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  8. Takeshi Kimbara
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  9. Makoto Kako
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Corresponding author

Correspondence to Kazuya Koizumi.

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Conflict of Interest

Kazuya Koizumi, Sakue Masuda, Haruki Uojima, Chikamasa Ichita, Shinnosuke Tokoro, Akiko Sasaki, Hideto Egashira, Takeshi Kimbara and Makoto Kako declare that they have no conflict of interest.

Human/Animal Rights

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008(5).

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Informed consent was obtained from all patients for being included in the study.

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Koizumi, K., Masuda, S., Uojima, H. et al. Endoscopic ultrasound-guided drainage of an amoebic liver abscess extending into the hepatic subcapsular space. Clin J Gastroenterol 8, 232–235 (2015). https://doi.org/10.1007/s12328-015-0585-8

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  • DOI: https://doi.org/10.1007/s12328-015-0585-8

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