Imaging of Parasitic Infections in Liver: Amebiasis

           Imaging of Parasitic Infections in Liver: Amebiasis

Fig: Patient 1 is a case of liver abscess in the right lobe and thickened ascending colon in the            second image. Patient 2 is a case of multiple liver abscess due to amebiasis. 

Etiology: Entamoeba Histolytica

Route of infection: Feco-oral or sexually transmitted

Frequency of liver complication: 3 - 9 %

 Life Cycle: The trophozoites migrate to large intestine and then invade the intestinal mucosa and through the blood stream spreads to other parts of body (mainly liver, lungs and brain)

Diagnosis: Serology

Imaging: Sensitive but not specific. Usually ultrasound suffices. 

1. Margins: Well defined or irregular / nodular

2. Perilesional edema

3. Content: Complex fluid with higher HU value on CT or echoes on ultrasound as compared to the cyst. Internal septations are seen representing breaking of the parenchymal tissue

4. Multiple - Immuno-compromised patient /elderly / alcoholism

5. Location: More commonly seen in the right lobe and near diaphragm.

6. Tip: Always look for colonic thickening. 

7. Complications: Hepatic vein invasion / thrombosis of vein / pulmonary embolism of abscess content / abscess rupture

Management: 

1. Oral Antibiotics

2. Image guided drainage: Only if they are less than a cm from the surface and have potential to rupture

Prepared by Dr. Sharad Maheshwari

12.9.2023

Updated: