Ewha Med J.  2011 Sep;34(2):60-63. 10.12771/emj.2011.34.2.60.

Recurred Cryptogenic Liver Abscess Secondary to Colon Cancer in a Non-diabetic Man

Affiliations
  • 1Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea. thkim@ewha.ac.kr

Abstract

The causes of pyogenic liver abscess has been known as biliary tract disease or intrabadominal infection but the large proportions of the patients has no apparent underlying disorders. Recently colonic mucosal lesions were reported in patients with cryptogenic liver abscess and it has been suggested that colonic mucosal break may play a role in developing liver abscess in otherwise healthy patients. We experienced a patient of severe recurrent liver abscess complicated with endophthalmitis only 3 months after successful treatment of initial cryptogenic liver abscess and a polypoid colon cancer was discovered by chance. It seems prudent to proceed colonoscopic examination in patients with cryptogenic liver abscess especially when it is recurrent.

Keyword

Liver abscess; Recurrence; Colon cancer; Klebsiella pneumoniae

MeSH Terms

Biliary Tract Diseases
Colon
Colonic Neoplasms
Endophthalmitis
Humans
Klebsiella pneumoniae
Liver
Liver Abscess
Liver Abscess, Pyogenic
Recurrence

Figure

  • Fig. 1 Abdominal CT findings. (A) There are organized abscess in S8 after the first optimal treatment of liver abscess. (B) Newly appeared liver abscess in S7 is noted only after 3 month.

  • Fig. 2 Gross finding of colon polyp. About 2.4 cm sized polyp of sigmoid colon was noted in colonoscopy. Polypectomy was done after snaring the stalk. The mass revealed adenocarcinoma with invasion into submucosa.


Reference

1. Nah BK, Kim YS, Moon HS, Park KO, Kim SM, Lee YS, et al. Recent changes of organism and treatment in pyogenic liver abscess. Korean J Hepatol. 2003. 9:275–283.
2. Lim SW, Lee EJ, Lee SW, Kim SM, Kim JH, Kim BJ, et al. Clinical significance of Klebsiella pneumoniae in liver abscess. Korean J Gastroenterol. 2003. 42:225–231.
3. Lai HC, Chan CY, Peng CY, Huang WH. Pyogenic liver abscess associated with large colonic tubulovillous adenoma. World J Gastroenterol. 2006. 12:990–992.
Article
4. Lim WC, Lim CC. Silent colorectal carcinoma and pyogenic liver abscess. J Gastroenterol Hepatol. 2004. 19:945–946.
Article
5. Lee JK, Kim J, Ghosh P. Nonmetastatic cancer of colon associated with pyogenic liver abscess. Am J Gastroenterol. 2008. 103:798–799.
6. Hiraoka A, Yamashita Y, Uesugi K, Koizumi Y, Yamamoto Y, Doi H, et al. Three cases of liver abscesses complicated with colon cancer without liver metastasis: importance of screening for digestive disease. Intern Med. 2007. 46:2013–2017.
Article
7. Huang CJ, Pitt HA, Lipsett PA, Osterman FA, Lillemae KD, Camerin JL, et al. Pyogenic hepatic abscess: changing trends over 42 years. Ann Surg. 1996. 223:600–609.
8. Lee JY, Na BK, Kim JH, Lee SH, Choi TH, Choi HY, et al. Septic metastatic lesions associated with Klebsiella pneumoniae liver abscess. Infect Chemother. 2006. 38:95–100.
9. Chiu CT, Lin DY, Liaw YF. Metastatic septic endophthalmitis in pyogenic liver abscess. J Clin Gastroenterol. 1998. 10:524–527.
Article
10. Yang CS, Tsai HS, Sung CS. Endogenous klebsiella endophthalmitis associated with pyogenic liver abscess. Ophthalmology. 2007. 114:876–880.
Article
11. Harris EW, D'Amico DJ, Bhisitkul R, Priebe GP, Petersen R. Bacterial subretinal abscess. A case report and review of the literature. Am J Ophthalmol. 2000. 129:778–785.
Article
12. Cheng HC, Chang WL, Chen WY, Kao AW, Chuang CH, Sheu BS. Long-term outcome of pyogenic liver abscess. J Clin Gastroenterol. 2008. 42:1110–1115.
Article
13. Lederman ER, Crum NF. Pyogenic liver abscess with a focus on klebsiella pnuemoniae as a primary pathogen. Am J Gastroenterol. 2005. 100:322–331.
14. Choi HY, Cheon GJ, Kim YD, Han KH, Kim KS, Nah BK. Comparison of clinical characteristics between cryptogenic and biliary pyogenic liver abscess. Korean J Gastroenterol. 2007. 49:238–244.
15. Zakout R, Santos JM, Ferreira C, Victorino RM. Colonoscopy for cryptogenic pyogenic liver abscess? Colorectal Dis. 2010. 12:71–73.
Article
16. Hsu WH, Yu FJ, Chuang CH, Chen CF, Lee CT, Lu CY. Occult colon cancer in a pateint with diabetes and recurrent klebsiella pneumoniae liver abscess. Kaohsiung J Med Sci. 2009. 25:98–103.
17. Weng SW, Liu JW, Chen WJ, Wang PW. Recurrent Klebsiella pneumoniae liver abscess in a diabetic patient followed by streptococcus bovis endocarditis-occult colon tumor plays an important role. Jpn J Infect Dis. 2005. 58:70–72.
18. Hiraoka A, Yamashita Y, Uesugi K, Koizumi Y, Yamamoto Y, Doi H, et al. Three cases of liver abscesses complicated with colon cancer without liver metastasis: importance of screening for digestive disease. Intern Med. 2007. 46:2013–2017.
Article
19. Cohen JL, Martin FM, Rossi RL, Schoetz DJ. Liver abscess: the need for complete gastrointestinal evaluation. Arch Surg. 1989. 124:561–564.
20. Nosher JL, Giudici M, Needell GS. Elective one stage abdominal operations after percutaneous catheter drainage of pyogenic liver abscess. Am Surg. 1993. 59:658–663.
21. Lai HC, Lin HC. Cryptogenic pyogenic liver abscess as a sign of colorectal cancer. a population-based 5-year follow-up study. Liver Int. 2010. 30:1387–1393.
Article
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