The patient is a 44-year-old male from South India with a travel history to South-East Asian countries. He presented to the hospital with mild but persistent abdominal pain localized to the upper right quadrant and a fever of 104 o F. Examination Physical examination was normal, including a normal breathing rate and no abdominal tenderness. Hematology panel and liver function tests were normal. Abdominal ultrasound revealed a mass in the liver. Triphasic CT scan showed a liver abscess in segment VIII measuring 7.5 cm x 6.8 cm x 6.1 cm.
Treatment Pigtail insertion and laparoscopic cholecystectomy were carried out. Approximately 5 cc of pus was aspirated from the larger cyst using a 21-guage Chiba needle. A 0.018 inch wire with a coaxial dilator and a 0.038-J-tip guidewire with larger dilators were inserted. 10Fr pigtail drainage catheter was inserted into the cyst. 170 cc of discharge…
