PMC4975706_01
(A) CT of the abdomen without contrast shows (green oval) ill-defined areas of heterogenous predominantly low attenuation throughout the medial segment of the left hepatic lobe, to a lesser degree within the lateral segment of the left hepatic lobe. Findings raise concern for a hepatic abscess. (B) Right upper ultrasound showing (white x's) complex mass with in the medial left lobe. The mass shows a heterogeneously hypoechoic echotexture and measures approximately 10.3 x 9.3 x 6.7 cm. (C) CT scan of liver after drainage shows (green arrows) decreased sized/conspicuity of irregular areas of decreased enhancement in the liver, primarily involving the left hepatic lobe, suggestive of sequelae of previous hepatic abscesses. (D) Right upper ultrasound after IR-guided drainage shows (white x's)10 cm area of heterogeneous echotexture secondary to residual abscess.
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His physical exam was unremarkable except for tenderness to palpation in the right upper quadrant (Fig. 1).