Fact-sheet: Hepatic abscess
Updated on 04/18/2017 at 7:07 AM
View all RADEOS cases associated with this fact-sheet
Definition
Organized intrahepatic collection.
Most often pyogenic.
Clinical features
Fever Right upper quadrant pain
that may radiate to the right flank or right shoulder
Laboratory findings
Leukocytosis
Elevated CRP
Elevated ESR
Radiography
May sometimes reveal right basal atelectasis, right pleural effusion, and elevation of the right hemidiaphragm.
Ultrasound
Organized hypoechoic collection within the hepatic parenchyma, with content of variable thickness, sometimes septated.
CT
Collection hypodense relative to the rest of the hepatic parenchyma, best seen on the portal venous phase after IV iodinated contrast injection
Irregular wall with strong enhancement, surrounded by a non-enhancing hypodense perilesional halo = double target sign.
Vascular intervention
Depending on location, and before considering surgical treatment, discuss the possibility of ultrasound- or CT-guided drainage.
Indication for drainage if:
- Size greater than 5 cm
- And negative blood cultures
Differential diagnosis
Alveolar echinococcosis
Hydatid cyst
Biliary cyst