30/06/2026
โโโA Case Of Pyogenic Hepatic Abscessโโโ
Clinical History (Hx):-
35 years male patient presented with fever, right upper quadrant pain and tenderness.
Ultrasound Findings:-
A well-defined hypoechoic lesion measuring approximately (111 ร 85 x 70 mm, Volume:- 660ml) is seen in the right lobe.
โขLesion shows irregular walls, internal low-level echoes, and no significant internal vascularity on color Doppler โ suggestive of pus content.
โขSurrounding parenchyma appears mildly hyperechoic (reactive changes).
โขNo calcification or gas foci seen within the lesion.
โขIntrahepatic biliary radicals: Normal caliber.
โขPortal vein and hepatic veins: Normal flow pattern.
Impression:- Findings are suggestive of A Pyogenic Hepatic Abscess involving the right lobe of liver.
Causal Explanation:
The abscess is likely secondary to bacterial infection, commonly due to ascending infection via the biliary tract, portal vein seeding from gastrointestinal infection, or hematogenous spread (e.g., from septic focus elsewhere).
Most frequent organisms: E. coli, Klebsiella, Staphylococcus.
Recommendations:
โขContrast-enhanced CT (CECT) Abdomen for confirmation and extent assessment.
โขAntibiotic therapy as per culture sensitivity (blood or aspirate).
โขImage-guided aspiration / pigtail drainage if lesion is large or not responding to medical therapy.
โขFollow-up ultrasound after 7โ10 days to monitor resolution.