[Amoebic Liver Abscess][Dr. O.P. Kapoor]
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CIRRHOSIS AND AMOEBIC LIVER ABSCESS

. Occurrence of an amoebic liver abscess in a case of cirrhosis is very rare. This is difficult to explain. Although alcohol predisposes to both cirrhosis and amoebic liver abscess, it is surprising that the occurrence of both the illnesses together is so uncommon. We have seen only one such case at autopsy. In the literature, there are only three cases reported. In the case of Viranuvatti et al1 the diagnosis of cirrhosis was confirmed on peritoneoscopy. The patient had a superior surface amoebic liver abscess, which had ruptured into the pleura. The case of Gulati et al2 was proved at autopsy. The third case was presented at a clinicopathological conference.3 Autopsy revealed post-hepatitis cirrhosis with an amoebic abscess of the left lobe with compression jaundice and perforative peritonitis.
An amoebic liver abscess always heals without leaving behind any evidence of cirrhosis of liver.
Subramaniam and Madangopalan4 believe that amoebiasis of the liver though not leading to cirrhosis per se, is definitely a contributory factor in the development of cirrhosis so prevalent in their hospital patients. Indeed it is the custom in these authors' wards to give anti-amoebic therapy to almost all patients with cirrhosis of liver! When Reddy et al5 did histological examination of the liver biopsy in 18 cases of amoebic liver abscess, no cirrhotic changes were seen in any of them. Also, none of the 173 cases of cirrhosis of liver which they analysed during the same period could be traced to amoebic etiology. Similarly Palmer6 in a study of 19 cases of amoebic liver abscess observed only patchy fibrosis and no evidence of cirrhosis.
Thus, it seems quite convincing that an amoebic liver abscess does not lead to cirrhosis of the Iiver.

References

  1. Viranuvatti, V, and Suksombati, P. Am. J Gastroent., 1964, 42, 420.
  2. Gulati, P D, Gupta, D N. et al, Am. J Med., 1967,42, 852
  3. Clinico-Pathological Conference Touro-lnfirmary, New Orleans, Am J. Gastroent., 1964, 41, 64
  4. Subramaniam, R. and Madangopalan, N. Amoebiasis, Sandoz's Monograph, 1970.
  5. Reddy, C D, and Subramaniam, K, Ind J. Med. Sci., 1962, 16, 203.
  6. Palmer, R B. Am. Med Ass. Arch. Path., 1938,25, 327.