Case Review: Ultrasound & CT of Amebic Liver Abscess - a podcast by Daniel J. Kowal, MD

In this radiology lecture, we discuss the ultrasound and CT appearance of amebic liver abscess.

Key points include:



* Entamoeba histolytica infection.

* Endemic in Africa, Southeast Asia, and Central & South America.

* More common in males.

* Presents as right upper quadrant pain, fever and hepatomegaly.

* Both amebic and pyogenic (bacterial) abscesses can have a layered wall with the “double target” or “double rim” sign.

* Amebic more likely to be unilocular (septations present in 30%) without “cluster” sign typical of multiloculated pyogenic abscess.

* Amebic more likely solitary, pyogenic more likely multiple.

* Can be treated medically (metronidazole), but if diagnosis uncertain, if there is failed response to medical therapy, or if large abscess at risk for rupture = aspiration.



Bächler P, Baladron MJ, Menias C, et al. Multimodality Imaging of Liver Infections: Differential Diagnosis and Potential Pitfalls. RadioGraphics 2016 36:4, 1001-1023.

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