Clinical Profile in Patients of Amoebic Liver Abscess with and without Hyperbilirubinemia: A Prospective Cohort Study
Published: January 1, 2024 | DOI: https://doi.org/10.7860/JCDR/2024/68554.18948
S Sujitha, Rajiv Ranjan Kumar, Jitendra Kumar, Rekha Dewan
1. Resident (Post PG MCH), Department of Plastic and Reconstructive Surgery, Madurai Medical College, Maduari, Tamil Nadu, India.
2. Associate Professor, Department of Radiology, Dr. Baba Saheb Ambedkar Medical College and Hospital, Rohini, New Delhi, India.
3. Assistant Professor, Department of General Surgery, Dr. Baba Saheb Ambedkar Medical College and Hospital, Rohini, New Delhi, India.
4. Senior Specialist, Department of General Surgery, Dr. Baba Saheb Ambedkar Medical College and Hospital, Rohini, New Delhi, India.
Correspondence
Jitendra Kumar,
Dr. Baba Saheb Ambedkar Hospital, Sector-6, Rohini, New Delhi, India.
E-mail: jkumar33@ymail.com
Introduction: In tropical countries like India, two-thirds of liver abscess cases are amoebic. Along with abdominal pain, fever, and other non-specific clinical features, jaundice is commonly observed in Amoebic Liver Abscess (ALA) cases. However, the understanding of jaundice in a patients with ALA is limited, and it is associated with a poor prognosis.
Aim: To compare the morbidity and mortality of ALA patients with and without hyperbilirubinemia, as well as their clinical outcomes.
Materials and Methods: The present prospective cohort study was conducted at a tertiary teaching institute in northern India. It included 150 patients aged between 20 and 60 years with a confirmed diagnosis of ALA. The patients were divided into two groups based on the presence or absence of hyperbilirubinemia. Those with jaundice resulting from other causes or a history of hepatitis were excluded. Variables examined in the study included age, sex, alcohol intake, basic laboratory parameters, ultrasound-assessed abscess size and number, and duration of hospital stay.
Results: Among the 150 cases, 22 (14.6%) had elevated serum bilirubin levels (>1 mg/dL). Additionally, 122 (81.33%) had a history of alcohol intake, and 117 (78%) had a single abscess cavity. In ALA patients with hyperbilirubinemia, 12 (54.55%) had abnormal creatinine values, and 6 (27.26%) experienced complications such as rupture and peritonitis. One mortality occurred in a patient with ALA and jaundice.
Conclusion: ALA patients with jaundice exhibited larger abscess cavities, a higher complication rates, a longer hospital stays, and a poor prognoses.
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