Radiology: Liver abscess

Occasionally, a space occupying hepatic lesion is nothing more than a collection of bacteria and cellular debris- an abscess.  Although attempts at IV antibiotics are sometimes worthwhile in the non-toxic patient, percutaneous drainage is often necessary. 

When you are faced with a hepatic abcess, you must search for the underlying cause.  A diseased biliary tree is frequently culpable, though entities like diverticulitis and cholecystitis should be excluded.  Primary infection, from the parasite E. histolytica should also be excluded.  If no source turns up, maybe it’s just a case of hematogenous seeding from a generalized bacteremia.

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