Colonoscopy for ‘cryptogenic’ pyogenic liver abscess?

Cryptogenic pyogenic liver abscess as a sign of colorectal cancer: a population-based 5-year follow-up study

“…These bacteria are colonizers in the human gastrointestinal tract. The defect in the mucosal barrier caused by colorectal cancer or large adenomas predispose to microbial seeding to the portal venous system and into the liver, resulting in abscess formation (11, 18).…”

“…Recent reports assert that cryptogenic PLA might be a presentation of occult or silent colorectal cancer or adenoma without any gastrointestinal symptoms on admission (5,7,8,14 (12). Colorectal cancer or large adenomas can induce loss of integrity of the normal mucosal barrier (11,18). The mechanism that explains how colorectal cancer or adenoma can be involved in the aetiology of cryptogenic PLA is probably that mucosal defects offer a route for bacterial invasion into the portal system, which consequently arrives at the liver (11,18,30).…”

“…These bacteria are colonizers in the human gastrointestinal tract. The defect in the mucosal barrier caused by colorectal cancer or large adenomas predispose to microbial seeding to the portal venous system and into the liver, resulting in abscess formation (11,18). Patients with diabetes are known to show defects in neutrophil chemotaxis and phagocytosis, which are thought to be the most important predisposing factors for K. pneumoniae-pathogenic liver abscess (33).…”

“…Some PLAs were idiopathic -namely, cryptogenic abscesses. In many reports, cryptogenic PLA has been regarded as the first manifestation of silent colorectal cancers and colonic tubulovillous adenomas (5)(6)(7)(8)(9)(10)(11)(12)(13). If a patient has a previous colon lesion (e.g.…”

Recent upper gastrointestinal panendoscopy increases the risk of pyogenic liver abscess

“…Therefore, the documented risk factors for PLA include diabetes mellitus (DM)[1,7], end-stage renal disease (ESRD)[8,9], biliary tract infection (BTI)[10], liver cirrhosis[11,12], colorectal cancer[13-17], hepatobiliary tract cancer[18,19], and endoscopic retrograde cholangiopancreatography (ERCP)-related biliary tract procedures[20-23]. In addition, serial case reports have also demonstrated that acute appendicitis or diverticulitis may result in PLA through bacterial spreading from portal systems[24-29].…”