DIAGNOSIS AND TREATMENT OF AMEBIC LIVER ABSCESS * By RYLE A. RADKE, Colonel, MC, F.A.C.P., Chief of Medical Service, Tokyo Army Hospital, 8059th Army Unit

THAT diagnostic difficulties are attendant upon the management of amebic liver abscess is attested by the frequency with which the condition is discovered at autopsy when the clinician did not suspect its presence. In a group of 40 autopsy cases of liver abscess due to amebiasis studied at the Armed Forces Institute of Pathology the attending physician had the cor-rect diagnosis in but seven (17.5 per cent). Invasion of the liver un-doubtedly occurs in every patient with amebiasis, and many patients with amebiasis have a large, tender liver (hepatomegaly) (43 to 50 per cent).1 However, the incidence of liver abscess in amebiasis is much less (1 to 18 per cent).2 The probable explanation of this phenomenon is that advanced by Rogers,8 of presuppurative hepatitis. It is agreed that the diagnosis of amebic liver abscess is upon firm ground only when the amebas have been demonstrated in the exudate or by a biopsy from liver or pleura. However, this is an unsatisfactory criterion from the clinical point of view, because adequate therapy should result in resolutio