Patient was put on antibiotics. Anticoagulants like heparin and acitrom were started. USG Guided pig tail catheter insertion done and liver abscess drained.

E.histolytica infection most commonly presents as amoebic colitis and liver abscess. Pyogenic liver abscess is caused by organisms like Klebseilla pneumoniae, E.coli, Staphylococcus and Enterococcus.[3, 5]Clinical features of a liver abscesswould include fever, pain over the right upper quadrant or abdomen or epigastrium with/without radiation to right shoulder tip. On palpation enlargement of liver, liver tenderness, localized intercostal tenderness may be present[6].Both ultrasonography and CT are widely used for the detection of liver abscess. The sensitivity of CT is far superior as it can visualize an impending perforation, ruptured abscess and obstruction of venous channels, although venous obstruction can be better visualized with a multiphasic CT angiography. Multiple lesions are seen in acute disease whereas in chronic cases solitary lesions are more common.[3] Right lobe of the liver is the most common site of abscess formation compared to the left. If abscess is present in caudate lobe of liver then aspiration of abscess using a catheter is tricky as the abscess is deep seated and surrounded by multiple vessels- in which case surgical approach is considered as last resort.[1] Complications of liver abscess includes rupture into pleura through diaphragm or hematogenous spread to the lungs causing pleural effusion/pneumonitis, rupture into pericardium causing pericarditis/cardiac tamponade, intraperitonial rupture causing peritonitis.[3, 4, 6] Other rare complications include inferior vena caval /hepatic/portal and deep vein thrombosis.[1]Venous thrombosis is a rare but life threatening complication as it can lead to pulmonary embolism. In this case study the patient is found to have multiple abscess involving the 7^th and 8^th segments of liver along with deep vein thrombosis of bilateral iliac veins, common femoral veins, superficial femoral veins, popliteal veins and the great saphenous veins. The patient did not have any risk factors pertaining to deep vein thrombosis like surgery, trauma, hospital/nursing home confinement, myocardial infarction, congestive heart failure, varicose veins, liver disease, central venous catheter/pacemaker, neurological disease with extremity paresis or malignant neoplasm.[7] The patient was treated with antibiotics and anticoagulants (heparin and acitrom). The abscess was drained using a pigtail catheter.