A 25-year old patient presented with cough and blood in sputum for 10 days. Imaging findings showed a soft tissue opacity in the right mid and lower lung zone, indicating a pleural effusion and loss of the right diaphragm silhouette. Ultrasound showed a 52x42mm echogenic liver lesion with thick walls in segment VII of the right lobe, as well as an 85x28mm hypoechoic subpulmonic collection suggestive of a liver abscess. CT scan revealed a 42x43mm thick-walled cystic lesion in the liver segment VII reaching the subcapsular region with a 6mm rent communicating to the right thoracic cavity, indicating a ruptured liver abscess extending into the

2. CASE HISTORY
•A 25 year old patient presented with chief
complain of cough and hemoptysis since 10
days.

3. SEQUENTIAL X RAY FINDINGS IN PAST MONTH

4. There is soft tissue opacity
seen over right mid and
lower zone with obliteration
of right costophrenic and
cardiophrenic angle and non
visualization of right dome
of diaphragm.
Present x ray

5. USG IMAGES

7. USG FINDINGS
•Minimal pleural effusion is noted on right side.
•Approx. 52 x 42 mm sized echogenic lesion with thick
hypoechoic rim is seen in right lobe of liver.
•Approx. 85 x 28 mm sized hypoechoic collection is seen in sub
pulmonic region on right side suggestive of liver abscess of
segment VII of right lobe of liver.

8. CT IMAGES

11. CT FINDINGS
•Approx. 42 x 43 mm sized thick walled with peripherally enhancing cystic
lesion is noted in segment VII of right lobe of liver reaching up to sub
capsular region with approx. 6 mm size rent is noted in its superior aspect
which appears communicating with thoracic cavity on right side with strip
of adjacent sub capsular free fluid.
•Intrathoracic abscess cavity is connected with terminal bronchial tree at
medial basal segment of right lower lobe.
•All findings suggestive of ruptured liver abscess with intrathoracic
extension and intrathoracic abscess cavity is connected with terminal
bronchiole tree at medial basal segment of right lower lobe.