Fig. 8. A morbidly obese 55-year-old woman with high fever.

A. Computed tomography (CT) shows two fluid collections in relation to the liver, one centrally and one peripherally in the right lobe. B. Corresponding to the CT scan, ultrasonography (US) demonstrates similar findings with a 12-cm complex mass containing both central and peripheral fluid collection. C-E. US-guided puncture with a 1.2-mm lumbar needle performed so that the needle traversed both fluid collections (C), aspirated pus from both sites, and subsequent contrast-enhanced ultrasonographic (CEUS) fistulography demonstrated no connection between the two cavities (D, central abscess; E, peripheral abscess). Consequently, two separate 7-F loop-catheters were placed, one in each collection. This case clearly demonstrates the added value of CEUS fistulography.