Presentation
Right arm mass (?melanoma) and 10kg LOW
Patient Data
Within segment IV of the liver there is a lobulated loculated low density lesion measuring 44 x 42 x 28 mm there appears to be contiguous with the gallbladder lumen. It has well defined margins, with a suggestion of a thin enhancing wall. No suspicious mass or nodularity. There is no pericholecystic fat stranding or wall thickening. No definite gallstone.
The portal and hepatic veins are patent. The spleen, adrenal glands, pancreas and kidneys are unremarkable. There is prostatomegaly. No gross bowel abnormality demonstrated.No abdominal lymphadenopathy.
No suspicious bone lesions.
Conclusion
Lobulated low density lesion within the segment 4 of the liver appearing to communicate with the gallbladder. The appearance is most in keeping with hepatic abscess related to previous gall bladder perforation.
Case Discussion
The patient underwent ultrasound-guided gallbladder aspirate (not shown) and Hafnia alvei was isloated (gram-negative bacteria, rare cause of infections).
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