[Amoebic liver abscess in general surgery at the Gabriel Touré teaching hospital, Bamako, Mali].

: The objectives were to determine the frequency, and to describe the clinical and therapeutic aspects of amoebic liver abscess. This was a retrospective study in the general surgery department of the Gabriel Toure teaching hospital from 1 January 2004 to December 2008. Included in this study, were all patients hospitalized and treated for amoebic liver abscess. We collected 53 cases a frequency of 1.3%. This was 45 men (84.9%) and 8 women (15.1%). The sex ratio was 5.6. The average age was 39.5 years. The average consultation time was 3 weeks. The signs observed were fever 96.2% (51 cases), the hepatalgia 94.3% (50 case), hepatomegaly 90.6% (48 cases) and anorexia 88.7% (47 cases). Collections of objectified abscess in abdominal ultrasound were located in the right lobe in 79.2% (42 cases), unique in 92.5% (49 cases) and 100 mm in diameter on average. Pulmonary radiography found an elevation of the right diaphragmatic dome 66.7% (14 cases). Amoebic serology was performed in 60.4% of cases, was negative in 2 cases (6.2%). Medical treatment alone was effective in the majority of cases - 62.7% (32 cases), an ultrasound-guided paracentesis associated with medical treatment was required in 31.4% (16 cases). Surgical methods were very rarely recommended 5.9 % (3 cases). The average amount of pus was 637.6ml. Average duration of treatment was 11 days. We recorded three deaths, including one due to a sepsis on peritonitis from ruptured liver abscess and 2 cases due to HIV. : Il s'agissait d'une etude retrospective realisee dans le service de chirurgie generale du CHU Gabriel Toure du 1er Janvier 2004 au Decembre 2008. Ont ete inclus dans cette etude tous les patients hospitalises et traites pour abces amibien du foie. Nous avons collige 53 dossiers soit une frequence de 1,3%. Il s'agissait de 45hommes (84,9%) et 8femmes (15,1%). Le sex-ratio a ete de 5.6 et la moyenne d'âge 39.5 ans. Le delai moyen de consultation a ete de 3 semaines. Les signes observes ont ete la fievre 96.2% (51cas), l'hepatalgie 94.3%(50cas), l'hepatomegalie 90.6% (48cas) et l'anorexie 88.7%(47cas). Les collections d'abces objectivees a l'echographie abdominale etaient localisees dans le lobe droit dans 79.2%(42cas), uniques dans 92.5%(49cas) et de 100 mm de diametre en moyenne. La radiographie pulmonaire de face a retrouve une surelevation de la coupole diaphragmatique droite 66,7% (14cas). La serologie amibienne effectuee dans 60.4% des cas, a ete negative dans 2 cas (6.2%). Le traitement medical seul a ete efficace dans la majorite des 62.7% (32cas), une ponction evacuatrice echoguidee associe au traitement medical a ete necessaire dans 31,4% (16 cas). Les methodes chirurgicales ont ete tres peu recommandees 5,9%(3cas). La quantite moyenne de pus a ete de 637.6ml. La duree Moyenne de traitement a ete de 11 jours. Nous avons enregistre 3 deces dont l'un suite a une septicemie sur peritonite par rupture d'abces du foie et les 2cas sur terrain VIH. CONCLUSION: L'abces amibien du foie est peu frequent dans notre service. La negativite de la serologie n'exclut pas le diagnostic. Le traitement medical est habituellement curatif en l'absence de complication.