A patient presents with abdominal pain and fever following an appendectomy. What is the most likely sonographic finding?

In the context of a patient experiencing abdominal pain and fever following an appendectomy, the most likely sonographic finding is the presence of an abscess. An abscess is a localized collection of pus that can occur as a complication after surgery due to infection. This can lead to increased inflammatory response and accumulation of fluid or pus in the abdominal cavity, which is detectable via ultrasound.

Ultrasound findings for an abscess typically include a hypoechoic or anechoic fluid collection with possible irregular margins and may exhibit internal echoes due to the presence of pus. Additionally, associated findings can include increased vascularity around the abscess on Doppler imaging and surrounding inflammatory changes.

In contrast, while hematomas are collections of blood that can also occur post-surgery, they are typically associated with bleeding and may not necessarily be detected as a focal area of infection leading to fever. Hepatomas, tumors of the liver, and metastatic lesions, which are secondary cancers, would not present so acutely following an appendectomy and are unlikely to be the cause of immediate fever and localized pain in the post-surgical context. Therefore, an abscess is the most relevant finding in this scenario, correlating closely with the clinical symptoms described.