If the liver has lesions confined to its surface and there is inflammation involving a peritoneal surface, what does this indicate about the infection?

• A. The bacteria originated from a distant site via the bloodstream.
• B. Liver is involved in a peritoneal infectious process.
• C. The infection is limited to liver parenchyma.
• D. Peritoneal infection does not involve the liver.

Answer: (B)

When the liver shows lesions only on its surface and there is inflammation on the peritoneal surface, it indicates the infection is centered in the peritoneal cavity with secondary involvement of the liver’s outer layer (the hepatic capsule). In other words, the liver is part of a peritoneal infectious process rather than being infected primarily within its own parenchyma or spread to the liver via the bloodstream. This pattern would not be explained by hematogenous spread producing parenchymal liver lesions, nor by an infection confined strictly to the liver parenchyma, and it contradicts the idea that the peritoneal infection spares the liver.