Published: 2022-01-29

A rare presentation of ruptured amoebic liver abscess with caecal perforation - a case series

V. Kopperundevi, Vimala G., Sai Vyshnavi Y., Kannan R.


A rare complication of simultaneous rupture of liver abscess with caecal perforation occurs mainly in malnourished patients and carries a high mortality rate. In invasive amoebiasis, the trophozoites penetrate the intestinal mucosal layer causing amoebic colitis which is carried along the portal circulation to produce liver abscess that is more prone to rupture in cases of immunocompromised status. Here we report 4 cases of ruptured liver abscess associated with caecal gangrene which were operated at our institute. All 4 patients were male who were chronic alcoholics and presented with ruptured amoebic liver abscess and simultaneous perforation of caecum that was identified on exploratory laparotomy. The different approaches to surgical management of these patients is discussed, wherein early identification and timely intervention remain as mainstay of treatment in all cases.


Ruptured liver abscess, Caecal gangrene, Perforation, Colitis, Immunocompromised

Full Text:



World Health Organization. Amoebiasis. Wkly Epidemiol Rec. 1997;72:97-100.

Majeed SK, Ghazanfar A, Ashraf J. Caecal amoeboma simulating malignant neoplasia, ileocaecal tuberculosis and Crohns disease. J Coll Physicians Surg Pak. 2013;13:116-7.

DeBakey ME, Oschner A. Hepatic amoebiasis – a 20 year experience and analysis of 263 cases. Int Abstr Surg. 1951;92:209-31.

Kean BH, Gilmore HR, Van Stone WW. Fatalamoebiasis-report of 148 fatal cases from Armed Forces Inst.of Pathology. Ann Int Med. 1956;44:831-8.

Rives JD, Heibner WC, Powe UJL. The surgical complications of amoebiasis of the colon. Surg Clin North Am. 1955;35:1421-6.

Radke RA. Ameboma of the intestine; An analysis of the disease as presented in 78 collected and 41 previously unreported cases. Ann Int Med. 1965;43:1048-66.

Mukerjee S, Nigam M. Amoebic perforation of the colon. Amer Proctol. 1975;26(2):57-64.

Eggleston FC, Verghese M, Handa AK. Amoebic perforation of the bowel: experience with 26 cases. Brit Surg. 1978;65:748-51.

Talukder BC. Surgical complications of amoebiasis and their diagnostic problems. Ind Med Assoc. 1978;70(8):187-9.