The clinical pattern and prognosis of patients with amebic liver abscess and jaundice

Abstract

Jaundice was found in 27 of 95 patients with amebic liver abscess hospitalized over a 5-year period. Serum bilirubin levels ranged from 2 to 31 mg/100 ml. The conjugated fraction was invariably predominant. Patients with jaundice had on the average a shorter duration of illness at admission, more frequent error in their initial clinical diagnosis, a higher incidence of complications, and a higher mortality rate when compared to patients without jaundice. At necropsy these patients demonstrated abscesses that were either on the inferior surface of the liver where main bile duct tributaries emerge or were of such a dimension as to compress this region. It is concluded that jaundice is of cholestatic origin due to compression or destruction of main intrahepatic biliary channels. The importance of recognizing its not infrequent occurrence, an early diagnosis, and effective aspiration in patients with amebic liver abscess and jaundice is highlighted.