Liver abscess: catheter drainage beat needle aspiration across 12 randomised trials

The edition in brief

A meta-analysis of 12 randomised trials and 1425 adults with liver abscess found percutaneous catheter drainage more likely to achieve clinical success than needle aspiration (OR 4.12, 2.01 to 8.45), consistently across abscess size and cause, with no difference in complications (OR 1.02, 0.30 to 3.50). Heterogeneity was moderate. Where liver abscess is common, as in India, it supports catheter drainage as the first percutaneous choice when drainage is needed. The American College of Radiology's 2026 update on postmenopausal acute pelvic pain keeps ultrasound as the first test, with MRI or CT when ultrasound is inconclusive, and highlights torsion, pelvic infection and fibroid complications in an age group where malignancy is more likely. Standardised technical guidelines for liver MR elastography state that a change in stiffness of at least 19% is needed before it can be called real with 95% confidence, based on a within-subject variation of about 7%. A German population study of 1037 men without prostate disease found PSA rose with age but PSA density stayed below 0.11 ng/mL² at every age, with a 95th percentile of 0.071. The pearl covers metformin and iodinated contrast.