Liver Abscess Differential Diagnoses
- Author: Ruben Peralta, MD, FACS; Chief Editor: John Geibel, MD, DSc, MA more...
Differential Diagnoses
- Biliary Disease
- Cholecystitis
- Empyema, Pleuropulmonary
- Gastritis, Acute
- Hepatocellular Carcinoma
- Hydatid Cysts
- Pneumonia, Bacterial
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