Hepatic manifestations during amoebic dysentery.

A variety of hepatic manifestations may occur during attacks of acute amoebic dysentery, conforming to clearly defined clinical groups. The incidence of definite hepatic involvement presenting as cases of hepatic amoebiasis with or without demonstrable pus or with tender hepatomegaly was 57·5%. While it is possible that the cases presenting with hepatic manifestations without demonstrable pus are due to small deep-seated abscesses, the non-specific nature of the histological lesions observed in the study and the inability to demonstrate the presence of amoebae in the lesions support the contention that these hepatic manifestations may represent a non-specific reaction in the liver to amoebic ulceration of the colon. Chest radiology may be helpful in confirming the clinical evidence of hepatic involvement but the leucocyte count, ESR, and the serum enzymes are of limited value in indicating both its presence and type. Patients manifesting hepatic involvement during attacks of amoebic dysentery should be adequately treated with tissue amoebicidals. This therapeutic approach would be useful in reducing the incidence of hepatic amoebiasis.