Arab Board Surgery Clinical

Practice session

A 36-year-old male who recently traveled to an endemic area presents with fever, right upper quadrant pain, and hepatomegaly. Serum Entamoeba histolytica ELISA antibody test is strongly positive. Abdominal ultrasound shows a solitary 5 cm hypoechoic liver abscess in the subcapsular region of the right lobe. Diagnostic aspiration yields thick, reddish-brown fluid resembling 'anchovy paste' without odor. What is the first-line definitive treatment?

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