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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.

This chapter discusses the water supply and sanitation situation in Rajasthan, particularly the spatial variation in the characteristics of the water supply systems. It describes the natural, physical, socio-economic and institutional environment which influences the access to drinking water sources and use of water, and access to and use of improved sanitation facilities in Rajasthan. It also reviews the existing policies and norms pertaining to rural water supply in the state to know as to what extent they address the public health concerns associated with climate variability in the state. It then maps the climate-induced WASH risk in all the districts of Rajasthan using a modified analytical framework for assessing climate risk, and validates it using data on public health status, with respect to incidence of water-borne diseases across the state. The WASH risk index was estimated to be varying from a lowest of 0.20 for Jaisalmer District to 0.40 for Sirohi District. The key factors contributing to high climate risk in certain districts and very low risks in certain other districts are identified.

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.