Comparative Analysis of Opisthorchosis and Non-parasitic Liver Abscesses

Aim: to perform comparative analysis of opisthorchosis and non-parasitic liver abscesses. Material and Methods. 46 patients with opisthorchosis and 43 patients with nonparasitic liver abscesses were treated. Results. Opisthorchosis liver abscesses occur 3 times more frequent than non-parasitic (2.65 and 0.85%, respectively) in the Tomsk region that is hyperendemic for opisthorchiasis. They develop because of prolonged (13.2 ± 2.4 years) and massive invasion due to suppuration of cholangiectasis and liver cysts. In 58.1% of cases it happens on background of extrahepatic cholestasis, in 93.5% has cholangiogenic character. They are preferably multiple – 58.1% (including military in 7%), have small size (65.1%), localized in SVII and SVI. Jaundice (53.5%), hepatomegaly (88.4%), acute renal
failure (30.2%), skin rash (86%), eosinophilia are more often (p < 0.05) observed in patients. Abscesses were recurrent in 15.2% of cases. Ultrasound as the main method of diagnosis allows to verify pathognomonic signs of opistorchosis (accuracy 96–100%), number, size, location of abscesses, their types depending on the prevalence of infiltrative or destructive processes, absence of capsule.
Intraportal infusion of antibiotics and other drugs, nasobiliary or transcapillary sanation of biliary system were used in case of infiltrative and miliary abscesses. Minimally invasive methods of treatment in case of formed abscesses are inefficient. Incision and drainage, as well as liver resection are indicated. Two-thirds of patients required cholecystectomy, bile passage restoration into duodenum by choledochoduodenostomy because of specific extended strictures of common bile duct and major duodenal papilla, external drainage of ducts from infection and helminths.Conclusion. Cholangiogenic opisthorchosis liver abscesses are more often multiple. Their clinical course is more severe. Open methods including liver resection are mainly indicated in the treatment 

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