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gas-forming pyogenic liver abscess, emphysematous liver abscess, Klebsiella pneumoniae
Gas-forming pyogenic liver abscess (GFPLA) is uncommon and reported high mortality rate. Diabetes mellitus and Klebsiella pneumoniae are the most frequent associated conditions and causative
organism. Gas collection is not often detected by plain film abdomen. On ultrasonography, gas appeared as hyperechoic foci with dirty shadowing, reverberation and ring-down artifacts. CT scan is the most
sensitive test for GFPLA. Early diagnosis, appropriate antibiotics, adequate drainage and plasma glucose control are essential management.
Figure 1 Plain film abdomen พบ multiple round and oval hypodensity gas pockets with air-fluid levels at right subphrenic region