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Pyogenic liver abscess

USU Teaching File MUTF - MedPix

View Article: MedPix Image - MedPix Case

Affiliation: Uniformed Services University

ABSTRACT

Diagnosis: Pyogenic liver abscess

History: Three day history of fever to 104?F, malaise, anorexia, nausea and vomiting, and right upper quadrant pain.

Findings: Two lesions within the liver, the largest in the posterior right hepatic lobe measuring 9 x 9 cm and 12.5 cm in its maximal craniocaudad dimension with low signal on T1 weighted images. The mass is heterogeneous and contains multiple internal septations with irregular internal walls. The second lesion is within the medial segment of the left hepatic lobe measuring 3 x 3.5 cm and is without septations. The biliary system is not dilated and the gallbladder is normal.

Ddx: The most likely etiology is abscess (pyogenic or amebic). Differential diagnosis also includes necrotic metastatic lesions, superinfected tumor, and less likely biliary cystadenoma/adenocarcinoma.

Exam: Mild scleral icterus present. Abdomen tense with right upper quadrant tenderness and positive Murphy’s sign. Liver span 14cm in midclavicular line. RUQ ultrasound shows a large mass with intermediate density in the posterior portion of the liver.WBC 21.8, Hbg 12.5, AST 271, ALT 384, Alk Phos 218, Total Bili 3.2, Negative blood cultures

No MeSH data available.


Two lesions within the liver, the largest in the posterior right hepatic lobe measuring 9 x 9 cm and 12.5 cm in its maximal craniocaudad dimension with low signal on T1 weighted images.  The mass is heterogeneous and contains multiple internal septations with irregular internal walls.  The second lesion is within the medial segment of the left hepatic lobe measuring 3 x 3.5 cm and is without septations.  The biliary system is not dilated and the gallbladder is normal.
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MPX1027_synpic17976: Two lesions within the liver, the largest in the posterior right hepatic lobe measuring 9 x 9 cm and 12.5 cm in its maximal craniocaudad dimension with low signal on T1 weighted images. The mass is heterogeneous and contains multiple internal septations with irregular internal walls. The second lesion is within the medial segment of the left hepatic lobe measuring 3 x 3.5 cm and is without septations. The biliary system is not dilated and the gallbladder is normal.


Pyogenic liver abscess

USU Teaching File MUTF - MedPix

Two lesions within the liver, the largest in the posterior right hepatic lobe measuring 9 x 9 cm and 12.5 cm in its maximal craniocaudad dimension with low signal on T1 weighted images.  The mass is heterogeneous and contains multiple internal septations with irregular internal walls.  The second lesion is within the medial segment of the left hepatic lobe measuring 3 x 3.5 cm and is without septations.  The biliary system is not dilated and the gallbladder is normal.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=MPX1027&req=5

MPX1027_synpic17976: Two lesions within the liver, the largest in the posterior right hepatic lobe measuring 9 x 9 cm and 12.5 cm in its maximal craniocaudad dimension with low signal on T1 weighted images. The mass is heterogeneous and contains multiple internal septations with irregular internal walls. The second lesion is within the medial segment of the left hepatic lobe measuring 3 x 3.5 cm and is without septations. The biliary system is not dilated and the gallbladder is normal.

View Article: MedPix Image - MedPix Case

Affiliation: Uniformed Services University

ABSTRACT

Diagnosis: Pyogenic liver abscess

History: Three day history of fever to 104?F, malaise, anorexia, nausea and vomiting, and right upper quadrant pain.

Findings: Two lesions within the liver, the largest in the posterior right hepatic lobe measuring 9 x 9 cm and 12.5 cm in its maximal craniocaudad dimension with low signal on T1 weighted images. The mass is heterogeneous and contains multiple internal septations with irregular internal walls. The second lesion is within the medial segment of the left hepatic lobe measuring 3 x 3.5 cm and is without septations. The biliary system is not dilated and the gallbladder is normal.

Ddx: The most likely etiology is abscess (pyogenic or amebic). Differential diagnosis also includes necrotic metastatic lesions, superinfected tumor, and less likely biliary cystadenoma/adenocarcinoma.

Exam: Mild scleral icterus present. Abdomen tense with right upper quadrant tenderness and positive Murphy’s sign. Liver span 14cm in midclavicular line. RUQ ultrasound shows a large mass with intermediate density in the posterior portion of the liver.WBC 21.8, Hbg 12.5, AST 271, ALT 384, Alk Phos 218, Total Bili 3.2, Negative blood cultures

No MeSH data available.