50 years old man came with complaint of fever and pain in abdomen for past one week. Ultrasound of abdomen was performed which revealed a hypoechoic lesion in liver. CECT was done to characterize the lesion . Which of the following statement is false regarding the lesion?
Correct Answer: Hematogeneous route is the most common source of infection.
Description: CT image shows a multilocular cystic mass in the posterior segment of the right hepatic lobe abutting the right hemidiaphragm. Note the layered wall ("double target sign") seen in pyogenic abscess. Pyogenic abscess can be divided into six categories based on the route of hepatic infection. These include: 1) biliary source (60%) (Most common) (Multiple abscesses are common) 2) poal vein seeding (7%)(2nd most common) 3) direct extension (3%); 4) hepatic aery seeding (10%) (usually monomicrobial) 5) cryptogenic (17%); 6) penetrating trauma (5%). Organisms: Solitary abscesses are more likely to be polymicrobial than multiple abscesses. E.coli - Most common in western countries Klebsiella pneumoniae - Most common in Asian countries Staphylococcus - Most common in children paicularly suffering from Chronic Granulomatous Disease (CGD). 50% of solitary liver abscesses occur in the right lobe of the liver (a more significant pa with more blood supply), less commonly in the left liver lobe or caudate lobe.
Category:
Radiology
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