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Liver abscess requiring drainage is conventionally managed by interventional radiology-guided percutaneous drainage (PCD). Radiologically inaccessible abscesses are managed with laparoscopic or open surgery, which carries high rates of morbidity and mortality. EUS-guided transluminal liver abscess drainage is minimally invasive and can be an alternative approach for caudate lobe, segment 4, and left lateral segment abscesses. We report on three consecutive patients with radiologically inaccessible left lobe liver abscess involving the caudate lobe, segment 4, and lateral segment in whom EUS-guided transluminal drainage using a modified technique was successful.

Biliary communication in hepatic hydatid cyst is reported in 1–20% of patients. These patients present with fever (70–90%), right upper quadrant pain (80%), cholangitis (20–37%), acute pancreatitis (rare), liver abscess, and septicemia. Diagnosis of biliary rupture is on abdominal ultrasound, computerized tomography, and/or magnetic resonance imaging demonstration of hydatid membranes. We report a case of rupture hydatid cyst where diagnosis was on endosonographic findings and the patient had normal caliber common bile duct.