Complicated versus uncomplicated amoebic liver abscess in adult: A prospective analysis of clinical presentation, disease course, and outcomes

Amoebic liver abscess (ALA) is often associated with significant complications. Contemporary prospective data comprehensively characterizing complicated and uncomplicated ALA are limited. This prospective cohort study followed 150 patients with ALA and found that 60.7% experienced at least one complication. The significant complications were peritoneal rupture, pleural rupture, venous thrombosis, biliary fistula, secondary bacterial infection, and organ dysfunction. Patients with complicated ALA had larger abscesses, higher inflammatory markers, and greater liver dysfunction than those without complications. The types of complications were influenced by the location of the ALA. Additionally, subcapsular abscesses and lower baseline HDL-cholesterol levels were independently linked to complicated cases of ALA. Although complications were common, both groups showed favourable outcomes. Mortality was 2%, occurring only in the complicated group. At three months, both groups had comparable rates of symptom resolution, cavity disappearance, and relapse.