Diagnosis: Liver abscess
Modality: CT
Clinical Presentation:
- Hepatic abscess is a rare but serious infection of the liver that may result from a variety of causes, such as biliary tract disease, diverticulitis, or blood-borne infections.
- Patients with hepatic abscess may present with symptoms such as fever, abdominal pain, nausea, vomiting, and weight loss.
- In some cases, patients may develop jaundice or signs of sepsis.
Findings on Imaging:
- Imaging studies such as abdominal ultrasound or CT may show evidence of one or more fluid-filled cavities within the liver, surrounded by a thick wall.
- The abscess may contain air or gas, which is an indication of a gas-forming organism.
- In some cases, imaging may also reveal evidence of an underlying cause of the abscess, such as a bile duct stone or tumor.
- Abscess from gas-producing organisms. CT scan illustrates a large low attenuation abscess with numerous foci of air consistent with gas-producing organisms.
Next Steps in Management:
- Management of hepatic abscess typically involves antibiotic therapy to treat the underlying infection, as well as drainage of the abscess to remove the infected material.
- Drainage may be performed using percutaneous aspiration, image-guided catheter placement, or surgical intervention.
- In some cases, the underlying cause of the abscess may also need to be addressed, such as with biliary duct decompression or resection of a malignant tumor.
Key Take Away Points:
- Hepatic abscess is a rare but serious infection of the liver that may result from a variety of causes.
- Imaging studies such as abdominal ultrasound or CT can help diagnose hepatic abscess by showing evidence of a fluid-filled cavity within the liver.
- Management of hepatic abscess typically involves antibiotic therapy and drainage of the abscess to remove the infected material.
Credit: Case submitted by Ellie Goulding M.D. to radRounds Radiology Network
