How are pyogenic hepatic abscesses treated?
At least 90% of pyogenic hepatic abscesses can be successfully drained percutaneously. Most pyogenic abscesses smaller than 3 cm in diameter are treated with antibiotics either alone or in combination with needle aspiration, with excellent success rates. For pyogenic abscesses larger than 4 cm in diameter, image-guided PCD is required. The size of the self-retaining, pigtail catheter inserted often depends on the viscosity of the fluid encountered.
The possibility of an abscess complicating an underlying hepatic neoplasm should always be considered. Follow-up imaging should be obtained to document eventual complete resolution of the lesion. FNA or core biopsy of any persistent abnormality may be necessary to exclude occult hepatic tumor.