A middle aged male with Large Liver Abscesses

A male aged 45 years p/w Chief Complaints Pain RUQ High Grade Fever Anorexia Vomiting (x 15 days) History Chronic Alcoholic Vitals BP- 106/66 mmHg PR- 102/min Investigations CECT W/A

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Cystic lesion in liver Cbc leucocytosis tenderness in rt lower chest confirmed liver abscess Capillary drainge Or repeated aspirations of abscess using usg Chloroquine metrogyl ciplox

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Cect thorex shows hypoechoeic shadow in liver.most likely amoebic liver abcess. Aspirate pus from liver abcess and examine pus culture and senstivity and for amoebic trpozoites and cyst.also examine stool for amoeba. Rx-Tab metrogyl 800mg 1×3 Tab chloroquine 250mg 1bd Tab becomplex 10d. Tab dilaxanide furoate (luminal amoebacide) 1×3 for 15days to 1month.

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Appears to be liver abscess Initially conservative t/t with antibiotics, metronidazole etc Rule out hepatocellular malignancy by asking for alphafetoprotein and CEA estimates ,FNAC Surgical intervention like Repeated Aspiration, pig tail catheter drainage may be reqd Rupture of liver abscess may require laprotomy or laparoscopic intervention

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Hypoechoic masses in liver

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