Ultrasound Pictures of “Abscess”

Note: Abscesses may form in any organ as a result of bacterial dissemination.
Occasionally they are preceded by an interventional procedure. The history may
narrow the differential diagnosis in these cases.

Clinical manifestations: unexplained fever, significant malaise; occasional dull
pain at the abscess site. A palpable mass may be noted, depending on the location
of the abscess.

“Ultrasound Pictures“ of Hepatic abscess caused by gas-forming organisms: hypoechoic mass (M) with high-level internal echoes (air). L = liver

“Ultrasound Pictures“ Splenic abscess: hypoechoic
splenic mass with ill-defined margins

Diagnosis: history; blood count, blood culture; sonography (scans may be directed
by clinical complaints)

“Ultrasound Pictures“ findings:
x Hypoechoic mass, usually with smooth but irregular margins
x High-level internal echoes with gas-forming organisms

Accuracy “Ultrasound Pictures“ diagnosis: The diagnosis can be made sonographically with high confidence. CDS and harmonic imaging are helpful. If doubt exists, ultrasound contrast agents can be used to confirm that the mass is avascular (unnecessary in most cases). The diagnosis is established by percutaneous aspiration and examination of the aspirate to identify the infecting organism and determine its antibiotic sensitivity. The abscess is evacuated in the same sitting, and if necessary it may be drained under sonographic guidance.