A 58-year-old woman presented with fever and right upper abdominal pain. She had cholecystectomy and choledochoenterostomy as a result of biliary stone disease 15 years ago. Laboratory findings showed WBC 20 910/mm3, ALP 191 IU/L [45-129], ALT 261 IU/L [5-35], Total Bilirubin 3.7 mg/dl and CA19-9 11.3 U/ml. Abdominal computed tomography (CT) showed a 6.5 x 5.2 cm irregular mass with peripheral rim enhancement. No definite calcified stone or stricture was noted at choledochoenterostomy site (Fig. 1). Under a diagnosis of liver abscess, empirical antibiotics were started and endoscopic retrograde cholangiopan-creatography (ERCP) was performed to rule out radio-lucent biliary stone, hidden stricture or malignancy.
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机译：一名58岁的妇女出现发烧和右上腹痛。 15年前因胆结石病而进行了胆囊切除术和胆总管造口术。实验室检查结果显示WBC 20 910 / mm3，ALP 191 IU / L [45-129]，ALT 261 IU / L [5-35]，总胆红素3.7 mg / dl和CA19-9 11.3 U / ml。腹部计算机断层扫描（CT）显示6.5 x 5.2 cm不规则肿块，周围边缘增强。在胆总管肠吻合处未见明确的钙化结石或狭窄（图1）。在诊断为肝脓肿的情况下，开始使用经验性抗生素，并进行内镜逆行胰胆管造影（ERCP），以排除放射性不透性胆结石，隐匿性狭窄或恶性肿瘤。
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