Q:

Which of the following statements most accurately describes the current therapy for pyogenic hepatic abscess?

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Which of the following statements most accurately describes the current therapy for pyogenic hepatic abscess?


  1. Antibiotics alone are adequate for the treatment of most cases.
  2. All patients require open surgical drainage for optimal management.
  3. Optimal treatment involves treatment of not only the abscess but the underlying source as well.
  4. Percutaneous drainage is more successful for multiple lesions than for solitary ones.

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C. Optimal treatment involves treatment of not only the abscess but the underlying source as well.

DISCUSSION: The development of ultrasonography and computed tomography (CT) in the past two decades has enabled earlier diagnosis and advances in treatment of hepatic abscess. Formerly, open surgical drainage was considered necessary in essentially all cases of pyogenic abscess. Numerous recent series, however, have reported high success rates and low mortality from the percutaneous catheter drainage of abscesses under CT or ultrasonographic guidance. Optimal management of pyogenic abscess, however, involves not only treatment of the abscess, whether by percutaneous or surgical methods, but correction of the underlying source as well. All modes of therapy are more successful in treating solitary lesions than multiple ones.

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