Liver abscess is an uncommon but potentially lethal complication of diverticulitis. Either may be present in an occult form. We present two cases to illustrate the diagnostic and therapeutic problems created by these occult presentations. A high index of suspicion and an aggressive diagnostic approach are necessary to ensure early diagnosis and proper treatment. Barium enema should be done in patients with liver abscesses when there is no obvious source for the abscess. Intraoperative evaluation of the liver, including needle aspiration of any suggestive areas, should be done in all patients operated upon for complicated diverticulitis. Patients with diverticulitis and abnormal results of liver function tests should have liver scan or abdominal sonography.
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