Image-guided percutaneous procedure plus metronidazole versus metronidazole alone for uncomplicated amoebic liver abscess

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Therapeutic aspiration in addition to metronidazole to hasten clinical or radiologic resolution of uncomplicated amoebic liver abscesses cannot be supported or refuted by the present evidence.

The most common complication of amoebiasis is the formation of a pus-filled mass inside the liver (liver abscess). Metronidazole is the drug of choice for treatment of amoebic liver abscesses, and this is followed by a luminal agent to eradicate the asymptomatic carrier state. However, a subset of patients with amoebic liver abscesses remains symptomatic, with a significant risk of rupture of the abscess into the peritoneum. The role of image-guided percutaneous therapeutic aspiration in these patients remains controversial. This review assesses the beneficial and harmful effects of image-guided percutaneous procedure plus metronidazole versus metronidazole alone in patients with uncomplicated amoebic liver abscess.

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