Needle aspiration of amoebic liver abscess.

OBJECTIVE--To determine the value of needle aspiration in uncomplicated amoebic liver abscess. DESIGN--Randomised case-control study with a minimum follow up of one year, comparing patients treated with drugs alone with those treated with additional needle aspiration. SETTING--Referral based gastroenterology clinic. PATIENTS--39 Consecutive patients with amoebic liver abscess in the right lobe, of whom 37 completed the study. INTERVENTION--Metronidazole 2.4 g/day was given to all patients for 10 days. Needle aspiration of the abscess was performed in 19 patients on the day of admission to hospital. MAIN OUTCOME MEASURES--Abdominal pain, fever, anorexia, and hepatomegaly were measured. Erythrocyte sedimentation rate, serum aspartate, and alanine aminotransferase activities, and alkaline phosphatase activity were also measured. RESULTS--Clinical improvement was similar in both groups of patients. Improvement in haematological and biochemical variables and rates of healing of cavities were also similar. CONCLUSIONS--Chemotherapy with potent tissue amoebicidal drugs such as metronidazole is optimally effective in treating amoebic liver abscess, and in uncomplicated cases routine aspiration is not required.