Pyogenic liver abscess complicating colonoscopic polypectomy

Gross, R; Reiter, Bruce P.; Korsten, Mark A.

doi:10.1016/j.gie.2007.08.028

Cited by 11 publications

(7 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“… 18 , 29 – 31 Similar cases have also been reported postpolypectomy, where polyp removal caused a microperforation in the colon. 32 Under these circumstances, bacteria gain access to the portal venous system and then to the liver bed. 8 , 20 In some of these cases, the HA was the presenting sign 30 and has been considered to be a herald of silent colon cancer.…”

Section: Infectious Abscessmentioning

confidence: 99%

The Evolving Nature of Hepatic Abscess: A Review

Mavilia

Molina

2016

JCTH

View full text Add to dashboard Cite

Hepatic abscess (HA) remains a serious and often difficult to diagnose problem. HAs can be divided into three main categories based on the underlying conditions: infectious, malignant, and iatrogenic. Infectious abscesses include those secondary to direct extension from local infection, systemic bacteremia, and intra-abdominal infections that seed the portal system. However, over the years, the etiologies and risks factors for HA have continued to evolve. Prompt recognition is important for instituting effective management and obtaining good outcomes.

show abstract

Section: Infectious Abscessmentioning

confidence: 99%

The Evolving Nature of Hepatic Abscess: A Review

Mavilia

Molina

2016

JCTH

View full text Add to dashboard Cite

show abstract

“…Recently, there have been many case reports of pyogenic liver abscess associated with various colonic diseases. The association with asymptomatic diverticulitis, 3,4 inflammatory bowel disease, 5–7 tubulovillous adenoma, 8,9 colon cancer, 10–19 and even colon polypectomy 20 have been reported. It has been believed that mucosal defects present within colonic lesions or a compromised mucosal barrier separating enteric bacteria from the circulation allows a route for bacteria invasion into the portal system, with subsequent hematogenous spread to the liver.…”

Section: Introductionmentioning

confidence: 99%

Cryptogenic pyogenic liver abscess as the herald of colon cancer

Jeong

Jang

Lee

et al. 2012

J of Gastro and Hepatol

View full text Add to dashboard Cite

show abstract

“…However, our patient did have tubulovillous adenomas and underwent colonoscopy. A few case reports suggest that tubulovillous adenomas are a risk factor for PLA, irrespective of the pathogenic microorganism [5,6,7] . Colonoscopy might cause mucosal defects at the site of the lesions providing a route for bacterial invasion of the portal system.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, there is a correlation between colonoscopy and the development of a PLA, although literature on the subject is scarce [8] , perhaps due to the difficulty in establishing a causal relationship between colonoscopy and liver abscess. A PLA after colonoscopy might be due to microperforations during colonoscopy, leading to bacterial invasion [6] .…”

Section: Discussionmentioning

confidence: 99%

The Development of a Liver Abscess after Screening Colonoscopy: A Calculated Risk?

Bac

2017

European Journal of Case Reports in Internal Medicine

View full text Add to dashboard Cite

We present the case of a patient who developed a liver abscess following screening colonoscopy. A colorectal screening program was introduced in the Netherlands in 2014 in order to reduce mortality from colorectal cancer. The patient in this report, a 63-year-old man with no significant medical history, underwent polypectomy of two polyps. Four days afterwards he presented to our emergency department with fever, nausea and vomiting. He was diagnosed with a Klebsiella pneumoniae liver abscess and was successfully treated with antibiotics for 6 weeks. This case highlights one of the risks of screening colonoscopy. Given the high number of colonoscopies due to the colorectal screening programs, we should be aware of complications in this mostly asymptomatic group of patients. LEARNING POINTS• Screening colonoscopy is a potential risk factor for Klebsiella pneumoniae liver abscess.• It is thought that microperforations during colonoscopy could lead to bacterial invasion causing a pyogenic liver abscess.• We expect the numbers of complications, including pyogenic liver abscess, to grow due to the increase in population-based screening programs for colorectal carcinoma. KEYWORDS (Pyogenic) liver abscess, Klebsiella pneumoniae, colonoscopy, screening CASE DESCRIPTIONA 63-year-old man was scheduled for colorectal screening because of his age. He had atrial fibrillation, an inguinal hernia and a herniated nucleus pulposus. As an immunoassay faecal occult blood test (iFOBT) showed occult blood in his faeces, he underwent a screening colonoscopy. The colonoscopy revealed diverticulosis and three polyps, two of which were removed by polypectomy. The first polyp was located in the caecum and the second in the descending colon. The third polyp (Fig. 1), located in the hepatic flexure, was left in situ for endomucosal resection (EMR) in the near future. The patient returned home after colonoscopy. However, 4 days later he presented to the emergency department with fever, nausea and vomiting. His blood results showed a high C-reactive protein (251 mg/l, normal range 0-10 mg/l) and elevated liver enzymes (ALAT 169 IU/l, normal range 0-35 IU/l). Sonography of the abdomen showed a mass measuring 5.7×4.6 cm in the right liver lobe. Computed tomography (CT) of the abdomen confirmed this liver abscess but showed no other abnormalities (Fig. 2).

show abstract

Pyogenic liver abscess complicating colonoscopic polypectomy

Cited by 11 publications

References 10 publications

The Evolving Nature of Hepatic Abscess: A Review

The Evolving Nature of Hepatic Abscess: A Review

Cryptogenic pyogenic liver abscess as the herald of colon cancer

The Development of a Liver Abscess after Screening Colonoscopy: A Calculated Risk?

Contact Info

Product

Resources

About