Etiology and Epidemiology
Etiology.—The dislodgment of amoebae-containing material from amoebic intestinal ulcerations and the plugging of the portal capillaries by such emboli give us the starting point of a liver abscess. The exciting cause is Entamoeba histolytica which in the liver continues the same production of a gelatinous necrosis as is carried on in the submucosa of the large intestine or appendix.
This pathogenic amoeba is fully described under amoebic dysentery.
As to obtaining a history of amoebic dysentery in liver abscess cases we have the following statistics:
| 500 cases with dysentery findings in 60% | (Kartulis). |
| 444 cases with dysentery findings in 59% | (Zancarol). |
| 500 cases with dysentery findings in 85% | (Kelsch and Kiener). |
| 63 cases with dysentery findings in 90.5% | (Rogers). |
| 38 cases with dysentery findings in 85% | (Seamen’s hospital autopsies). |
Amoebic liver abscess is exceedingly rare among children and probably 10 times less common among women than men.
Of 40 cases of liver abscess Waring noted intemperance in 67.5% and authorities generally insist upon the importance of the abuse of alcohol as a predisposing factor.
Natives of India very rarely develop liver abscess but it has been noted that when they begin to follow the customs of Europeans, as to eating and drinking, such lesions become more common in them.
As to the proportion of cases of amoebic dysentery which give rise to liver abscess only the statistics of those who have differentiated between bacillary and amoebic dysentery are of any value. Such statistics would indicate that about 20% of the cases of amoebic dysentery are complicated by liver abscess.