Right upper quadrant pain and fever.
Triphasic liver CT
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A large irregular fluid-density lesion involving the dome (segment VIII) and segment V of the right hepatic lobe as well as segment IV of the left lobe showing rim enhancement (inner rim) and a thin outer ring of hypoattenuation ("double target sign"). There are multiple smaller peripheral lesions, mostly noted at segment VIII with similar characteristics. Some of these appear coalescent forming "cluster sign". The remainder liver parenchyma is unremarkable. Portal vein and hepatic veins are patent.
The common bile duct is patent along its entire course with pneumobilia extending to intrahepatic biliary ducts surrounding the lesion.