Profil et prise en charge de l'abcès amibien du foie en milieu rural sénégalais

Abstract

Introduction: The characteristic clinical picture of liver abscess remains the Fontan triad. The amoebic nature of the abscess is most often retained based on epidemiological arguments associated with the chocolate appearance of the pus which is sterile on culture. In Senegal, there are few studies on amoebic abscesses. The objective of this study was to describe the profile and management of cases of amoebic liver abscess in rural Senegal. Methods: This was a retrospective descriptive study of patients treated for amoebic liver abscess in the 03 major public hospitals in the Thies. Results: We collected 50 cases. The mean age of the patients was 38.7 years 13.7. There was a male predominance (70%). Smoking, a history of dysentery and alcoholism were the main risk factors. Right upper abdominal pain was the main reason for consultation (76.0%). The puncture fluid was chocolate-coloured in 54% of cases. Amebic serology was positive in 36%. The mean delay of diagnosis was 11.10 days ± 6.97. All patients had received antibiotic therapy, which was combined with ultrasound-guided (36%) or scanner-guided (4%) liver aspiration, transcutaneous drainage (40%) and surgical drainage (8%). Twenty-three patients (46.0%) developed complications. The hospital mortality rate was 8%. Conclusion: In rural Senegal, the amoebic nature of liver abscesses is often accepted based on a several arguments. The course is generally benign.