Hepatic abscess - wedge-shaped perfusion abnormality

Case contributed by Dr Servet Kahveci

Presentation

On colonoscopy, there was a suspicious lesion in the sigmoid colon and biopsy was done. For this reason an ultrasound examination was performed. On USG, a hypoechoic lesion that could not be characterized was seen in the right lobe. A CT examination was therefore performed.

Patient Data

Age: 60 years
Gender: Male

A hypodense nodular lesion is seen in the right lobe of the liver. Note the wedge-shaped enhancement in the adjacent liver parenchyme.

There was a suspicious wall thickening in the sigmoid colon as well.

Hypodense nodular lesion is seen in the right lobe of the liver. Note the adjacent wedge-shaped parenchymal enhancement (yellow line). 

A suspicious wall thickening of the sigmoid colon is shown in the white circle. The examination of the colonic biopsy specimen revealed villous adenoma.

Case Discussion

In an attempt to take samples upon biopsy revealed hepatic abscess formation and the procedure was converted to an abscess drainage. Perilesional parenchymal enhancement may be a diagnostic clue for a hepatic abscess.

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