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PYOGENIC LIVER ABSCESS AS INITIAL PRESENTATION OF COLON CANCER: A CASE REPORT. Gastroenterol Nurs 2021; 43:470-473. [PMID: 33259434 DOI: 10.1097/sga.0000000000000558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Oh JH, Kang D, Kang W, Guallar E, Cho J, Min YW. Proton Pump Inhibitor Use Increases Pyogenic Liver Abscess Risk: A Nationwide Cohort Study. J Neurogastroenterol Motil 2021; 27:555-564. [PMID: 34642276 PMCID: PMC8521470 DOI: 10.5056/jnm20221] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 02/18/2021] [Accepted: 03/21/2021] [Indexed: 12/12/2022] Open
Abstract
Background/Aims Proton pump inhibitors (PPIs) increase gastric pH and alter the gut microbiome. An increased risk for infectious diseases has been reported in PPI users. However, little is known about the association of PPI use with pyogenic liver abscess (PLA) incidence risk. Methods We conducted a population-based cohort study using data from a nationwide representative sample of the Korean general population followed up for 10 years (January 1, 2003 to December 31, 2013). We identified PPI prescriptions and considered PPI as a timevarying variable. Proportional hazards regression model was used for incident PLA comparing PPI use versus non-use. Propensity score matching was also conducted. Results During the 4 209 229 person-years of follow-up, 58 595 participants had at least 1 PPI prescription and 541 patients developed liver abscess. The age-, sex-, residential area-, and income-adjusted hazard ratio for PLA incidence with PPI use was 4.19 (95% CI, 2.54- 6.92). The association was observed in fully adjusted models (hazard ratio 3.88; 95% CI, 2.33-6.44). The positive association between PPI use and PLA was consistent in all subgroups analyzed and in propensity score matching group. Conclusion The present data indicate that PPI use is associated with an increased PLA risk. Therefore, it is necessary to prescribe PPIs with clear indication and to avoid improper use of PPIs.
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Affiliation(s)
- Joo Hyun Oh
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.,Department of Medicine, Nowon Eulji Medical Center, Eulji University School of Medicine, Seoul, Korea
| | - Danbee Kang
- Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Science and Technology, Sungkyunkwan University School of Medicine, Seoul, Korea.,Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University, Seoul, Korea
| | - Wonseok Kang
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Eliseo Guallar
- Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University, Seoul, Korea.,Departments of Epidemiology and Medicine and Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA
| | - Juhee Cho
- Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Science and Technology, Sungkyunkwan University School of Medicine, Seoul, Korea.,Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University, Seoul, Korea.,Departments of Epidemiology and Medicine and Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA
| | - Yang Won Min
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Kogo H, Yamamoto K, Yoshida H. A case of transverse colon cancer with a large liver abscess that could be treated with a radical operation after infection control. Int J Surg Case Rep 2020; 77:182-186. [PMID: 33166816 PMCID: PMC7652707 DOI: 10.1016/j.ijscr.2020.10.122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 10/24/2020] [Accepted: 10/25/2020] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION Advanced colorectal cancer is known to be associated with liver abscesses. A strategy to treat liver abscesses as early as possible is necessary to ensure high surgical curability before the cancer progresses and to prevent worsening nutritional status of the patient during surgery. PRESENTATION OF CASE An 82-year-old woman was hospitalized due to fever. A 10 cm in diameter liver abscess and advanced colon cancer were diagnosed. After conservative treatment of the liver abscess with antibiotics and puncture drainage, colorectal cancer surgery was performed on a standby basis. DISCUSSION We propose that empiric antibiotic therapy should be administered early in cases of liver abscesses that may require early colorectal surgery. Abscess drainage should be performed promptly if the abscess is of a size that can be punctured easily. CONCLUSION In patients with advanced colorectal cancer complicated by liver abscesses that required early surgery, prompt drainage of the liver abscesses is mandatory.
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Affiliation(s)
- Hideki Kogo
- Department of Surgery, Nippon Medical School Tama-Nagayama Hospital, Tokyo, Japan.
| | | | - Hiroshi Yoshida
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School, Tokyo, Japan
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Giuliani A, Caporale A, Demoro M, Scimò M, Galati F, Galati G. Silent Colon Carcinoma Presenting as a Hepatic Abscess. TUMORI JOURNAL 2018; 93:616-8. [DOI: 10.1177/030089160709300618] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Penetration and abscess formation in an adjacent parenchymal organ as presentation of a colon cancer is very uncommon. We report a rare case of pyogenic liver abscess as the first manifestation of an infiltrative and penetrating hepatic flexure colon carcinoma without liver metastases. A 50-year-old woman was admitted with right abdominal pain, fever and chills. The initial diagnosis was a pyogenic liver abscess. Subsequent CT scan and colonoscopy evidenced a hepatic flexure colon cancer abscessed within segment 6 of the liver. Eight months after a right colectomy and liver resection there was no evidence of disease. The occurrence of a pyogenic liver abscess should raise the suspicion of a silent colon cancer.
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Affiliation(s)
- Andrea Giuliani
- Department of Surgery “Pietro Valdoni”, Policlinico Umberto I, La Sapienza University, Rome, Italy
| | - Alessandro Caporale
- Department of Surgery “Pietro Valdoni”, Policlinico Umberto I, La Sapienza University, Rome, Italy
| | - Martino Demoro
- Department of Surgery “Pietro Valdoni”, Policlinico Umberto I, La Sapienza University, Rome, Italy
| | - Michele Scimò
- Department of Surgery “Pietro Valdoni”, Policlinico Umberto I, La Sapienza University, Rome, Italy
| | - Francesca Galati
- Department of Surgery “Pietro Valdoni”, Policlinico Umberto I, La Sapienza University, Rome, Italy
| | - Gaspare Galati
- Department of Surgery “Pietro Valdoni”, Policlinico Umberto I, La Sapienza University, Rome, Italy
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Ballardini P, Gamberini S, Margutti G, Manfredini R. Hepatic Abscess and Silent Underlying Colon Cancer: An Emerging Association? TUMORI JOURNAL 2018; 94:624. [DOI: 10.1177/030089160809400435] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Pierluigi Ballardini
- Department of Internal Medicine, Hospital of the Delta, Lagosanto, Azienda USL of Ferrara, Italy
| | - Susanna Gamberini
- Department of Internal Medicine, Hospital of the Delta, Lagosanto, Azienda USL of Ferrara, Italy
| | - Guido Margutti
- Department of Internal Medicine, Hospital of the Delta, Lagosanto, Azienda USL of Ferrara, Italy
| | - Roberto Manfredini
- Department of Internal Medicine, Hospital of the Delta, Lagosanto, Azienda USL of Ferrara, Italy
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Lecoules S, Carmoi T, Klotz C, Rapp C, Perrot G, Galeano C, Algayres JP. Fièvre révélatrice d’un cancer colique : 11 observations. Rev Med Interne 2013; 34:136-40. [DOI: 10.1016/j.revmed.2012.08.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2008] [Revised: 07/08/2012] [Accepted: 08/08/2012] [Indexed: 12/26/2022]
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Koo HC, Kim YS, Kim SG, Tae JW, Ko BM, Lee TI, Jeong SW, Jang JY, Kim HS, Lee SH, Kim BS. Should colonoscopy be performed in patients with cryptogenic liver abscess? Clin Res Hepatol Gastroenterol 2013; 37:86-92. [PMID: 22572520 DOI: 10.1016/j.clinre.2012.03.037] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2012] [Revised: 02/17/2012] [Accepted: 03/28/2012] [Indexed: 02/04/2023]
Abstract
BACKGROUND/AIM The interruption of a mucosal barrier by colon cancer or a polyp can lead to the development of a liver abscess. This study aimed to evaluate the possible contribution of colon cancer to the development of liver abscess and the necessity of colonoscopy in patients presenting with cryptogenic liver abscess. METHODS We reviewed the medical records of 268 patients diagnosed with liver abscess between January 2001 and April 2010. Among cases with no definite cause of liver abscess, differences between patients with and without colon cancer were evaluated in terms of clinical, laboratory, imaging, and microbiological findings. RESULTS Pyogenic liver abscess with no apparent etiology was encountered 163 patients; colonoscopy was performed in 121 of these 163 patients. The tumor diagnosis was confirmed by total colonoscopy in 12/163 (7.4%) patients with adenocarcinoma and 8/163 (4.9%) patients with high-grade dysplasia. Nine patients were diagnosed with stage I, two patients with stage II, and one with stage III disease according to the tumor, nodes, and metastases (TNM) staging system for colorectal cancer. The prevalence of incidental colon cancer in patients with pyogenic liver abscess was significantly higher than that of normal individuals who underwent colonoscopy (0.8%, 90/11,272) at our health care center. CONCLUSIONS Colon cancer may be one etiology of liver abscess. Colonoscopy should be considered in patients with pyogenic liver abscess with not an apparent primary source of infection.
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Affiliation(s)
- Hyun Cheol Koo
- Department of Internal Medicine, Eulji University Hospital, Daejeon, Republic of Korea
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Chen YY, Lee JC, Yen HH, Wu SS, Soon MS. Pyogenic liver abscess and colorectal neoplasia: A case series. ACTA ACUST UNITED AC 2012; 44:848-51. [DOI: 10.3109/00365548.2012.690161] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Qu K, Liu C, Wang ZX, Tian F, Wei JC, Tai MH, Zhou L, Meng FD, Wang RT, Xu XS. Pyogenic liver abscesses associated with nonmetastatic colorectal cancers: An increasing problem in Eastern Asia. World J Gastroenterol 2012; 18:2948-55. [PMID: 22736918 PMCID: PMC3380322 DOI: 10.3748/wjg.v18.i23.2948] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2011] [Revised: 12/15/2011] [Accepted: 03/10/2012] [Indexed: 02/06/2023] Open
Abstract
AIM: To elaborate the clinicopathologic features of colorectal cancer-related pyogenic liver abscess (PLA).
METHODS: Reported cases of colorectal cancer-related PLAs were collected from the literature published up to October 2011 and evaluated for their clinicopathologic features. Data of collected cases included demographics, clinical presentation, microbial findings and treatment. Categorical variables were compared by χ2 analysis and continuous variables were evaluated using Student’s t test.
RESULTS: A total 96 cases of colorectal cancer-related PLA were collected from the previous literature. Most patients (60%) were male and 40% cases occurred in the age group of 61-70 years. Apart from some special types of PLA, there were significant differences in the microbiological spectrum between Eastern Asia and non-Eastern Asian countries, which implied different risk factors and courses of the disease. Gram negative bacteria especially Klebsiella pneumoniae (K. pneumoniae) PLA was predominant in Eastern Asia (80.0%) in contrast to non-Eastern Asian countries (P < 0.01). Meanwhile, most of the Eastern Asian patients exhibited smaller size of liver abscess and atypical presentation. Sigmoid colon and rectum (72.73%) were the main sites of tumor in Eastern Asian patients, whereas tumor sites were uneven among most of the non-Easter Asian PLA patients.
CONCLUSION: K. pneumoniae PLA was strongly associated with colorectal cancer, especially those occurring in sigmoid colon and rectum, in elderly Eastern Asian male patients.
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Abstract
Increasing incidence and microbiologic shift might have changed the manifestation of this condition. Pyogenic liver abscess has become a health problem in Taiwanese society. However, the extent of this problem has remained unclear because of the lack of a population-based study. We therefore performed a nationwide analysis of pyogenic liver abscess in Taiwan from 1996 through 2004. We analyzed 29,703 cases from the Taiwan National Health Insurance database and 506 cases from National Taiwan University Hospital. Our analysis showed that the annual incidence of pyogenic liver abscess increased steadily from 11.15/100,000 population in 1996 to 17.59/100,000 in 2004. Diabetes, malignancy, renal disease, and pneumonia were associated with a higher risk for the disease. By contrast, death due to pyogenic liver abscess decreased over time, although population-based abscess-related death increased slightly. Renal disease, malignancy, pneumonia, and heart disease correlated with higher death rates; Klebsiellapneumoniae infection and therapeutic procedures were related to lower death rates. Diabetes did not significantly change death rates for the 506 patients from the hospital.
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Lieuw-a-Fa M, Peringa J, Leeksma O, Terpstra W. Sepsis From Liver Abscesses in Metastatic Colorectal Carcinoma After Chemoimmunotherapy. J Clin Oncol 2008; 26:1381-2. [DOI: 10.1200/jco.2007.13.9220] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Affiliation(s)
- Mariska Lieuw-a-Fa
- Department of Internal Medicine, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands
| | - Jan Peringa
- Department of Radiology, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands
| | - Onno Leeksma
- Department of Hematology and Oncology, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands
| | - Wim Terpstra
- Department of Hematology and Oncology, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands
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Harnik IG. Pyogenic liver abscess presenting after malignant polypectomy. Dig Dis Sci 2007; 52:3524-5. [PMID: 17406839 DOI: 10.1007/s10620-006-9592-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2006] [Accepted: 08/31/2006] [Indexed: 02/07/2023]
Abstract
Streptococcus bovis bacteremia has been linked to the presence of occult colon cancer since 1977. We present a case of pyogenic liver abscess and bacteremia with a different Streptococcus viridans 1 week after colonic adenocarcinoma was removed via polypectomy, discuss the likely etiology and review whether there is evidence to support looking for colon cancer in patients who present similarly but have not already undergone screening.
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Affiliation(s)
- Ian G Harnik
- The Mount Sinai Hospital, Department of Medicine.
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