How is a hepatic abscess greater than 5 cm typically treated?

A hepatic abscess greater than 5 cm is typically treated with a combination of intravenous (IV) antibiotics and percutaneous drainage. This approach is considered the standard management for larger abscesses because it addresses both the infection and the abscess itself.

IV antibiotics are used to target the underlying infection, while percutaneous drainage helps to physically remove the pus or fluid collection, thereby providing symptomatic relief and reducing the risk of complications such as rupture or sepsis. Percutaneous drainage is often done under imaging guidance, such as ultrasound or computed tomography (CT), ensuring accurate placement of the drainage catheter.

In contrast, simply observing an abscess, especially one that is larger than 5 cm, is not considered adequate due to the potential for the abscess to expand or cause further complications. Treating with IV antibiotics alone would not sufficiently address the presence of the abscess itself, and surgical resection is typically reserved for cases where other treatments fail or if there are other complicating factors that necessitate surgical intervention. Thus, the combination of IV antibiotics and percutaneous drainage effectively manages the condition while minimizing the risks associated with larger hepatic abscesses.