Amebic liver abscess

Q: What is the differential diagnosis based on the CT images? show answer

A: Liver abscess and necrotic malignancy would be differential considerations.

Q: What are the most common organisms resulting in hepatic abscesses? show answer

A: Hepatic abscesses can be categorized as pyogenic (bacterial such as Escherichia coli, Klebsiella pneumoniae), parasitic (e.g. amebic or echinococcal), or fungal (e.g. Candida albicans).

Q: What are the most common routes of infection for hepatic abscesses? show answer

A: Hepatic abscesses can occur via the hematogenous route (portal vein or hepatic artery), biliary tract (e.g. ascending cholangitis), or direct inoculation (e.g. trauma or surgery).

Q: What are some ways to differentiate amebic hepatic abscess from other causes? show answer

A: In general, bacterial and fungal abscesses are often multiple, whereas amoebic abscesses are often solitary. Amoebic abscesses are more common in a sub-diaphragmatic location and are more likely to result in right pleural effusion and lung abscess. Since amoebic infection starts from the colon, colonic wall thickening may be seen with sparing of the ileum. Since the infection spreads to the liver via the portal vein, it most commonly occurs in the right hepatic lobe (probably due to an unequal distribution of superior and inferior mesenteric vein contents within the portal venous distribution).