Clin Endosc.  2019 Nov;52(6):620-623. 10.5946/ce.2018.185.

Pyogenic Liver Abscess Caused by Endoscopic Submucosal Dissection for Early Colon Cancer

Affiliations
  • 1Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea. tear9754006@yahoo.co.kr
  • 2Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea.

Abstract

Endoscopic submucosal dissection (ESD) is widely used for the treatment of colorectal neoplasia in patients who are candidates for endoscopic resection. In particular, pyogenic liver abscess (PLA), although rare, can occur. To our knowledge, there are no reports of PLA cases after ESD. Therefore, we report a rare case of PLA caused by ESD. A 76-year-old man was referred from a local clinic and admitted to our hospital for colonic ESD for a large polypoid mass. During colonoscopy, a 5-cm mass was seen in the cecum. ESD was performed. Four days after the procedure, he complained of myalgia and abdominal discomfort. Computed tomography revealed a 5.4-cm PLA in the medial segments of the liver. He was treated with antibiotics, and a percutaneous drainage catheter was inserted. Here, we report a very rare complication (PLA) after ESD. In conclusion, comprehensive awareness of the development of PLA is needed in ESD cases.

Keyword

Colonic neoplasm; Colonoscopy; Endoscopic submucosal dissection; Endoscopy; Liver abscess

MeSH Terms

Aged
Anti-Bacterial Agents
Catheters
Cecum
Colon*
Colonic Neoplasms*
Colonoscopy
Drainage
Endoscopy
Humans
Liver
Liver Abscess
Liver Abscess, Pyogenic*
Myalgia
Anti-Bacterial Agents

Figure

  • Fig. 1. (A) Colonoscopy image showing a 5-cm polypoid mass at the cecum. (B) The mass was removed be means of endoscopic submucosal dissection.

  • Fig. 2. (A) Computed tomography (CT) scan showing normal findings 14 days before endoscopic submucosal dissection. (B) CT with intravenous contrast revealed a 5.4-cm pyogenic liver abscess in the right lobe of the liver.

  • Fig. 3. The drainage catheter was placed with radiologic and ultrasonographic guidance.

  • Fig. 4. Two months after discharge, serial computed tomography scan showed complete resolution of pyogenic liver abscess.


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