Pediatric Pyogenic Liver Abscess

  • Etiology: caused by hematogenous spread from gastrointestinal tract / ascending cholangitis / superinfection of necrotic disease, commonly due to Escherichia coli and Klebsiella pneumoniae
  • Imaging: single or multiple in number, may involve one portion of liver or may be diffuse, vary in size from few mm several cm, may have rim enhancement, may contain septations or gas, cluster sign – small pyogenic abscesses coalesce into larger cavity
  • Clinical: presentation is fever, right-sided abdominal pain or weight loss, elevated liver function tests

Radiology Cases of Pyogenic Liver Abscess

AXR and CT of extravasation of TPN into the liver due to umbilical venous catheter perforation out of the vein
AXR AP shows the tip of the umbilical venous catheter to project over the left portal vein. Axial CT with contrast of the abdomen shows multiple low density lesions which appear to be joined together in the left lobe of the liver.