Case Report
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World J Gastroenterol. Feb 14, 2006; 12(6): 990-992
Published online Feb 14, 2006. doi: 10.3748/wjg.v12.i6.990
Pyogenic liver abscess associated with large colonic tubulovillous adenoma
Hsueh-Chou Lai, Cho-Yu Chan, Cheng-Yuan Peng, Chih-Bin Chen, Wen-Hsin Huang
Hsueh-Chou Lai, Cheng-Yuan Peng, Chih-Bin Chen, Wen-Hsin Huang, Division of Hepatology and Gastroenterology, Departments of Internal Medicine, China Medical University Hospital, Taichung, Taiwan, China
Cho-Yu Chan, Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, and Department of Medical Research and Education, Taipei Veterans General Hospital, Taipei, Taiwan, China
Correspondence to: Dr. Cho-Yu Chan, Associate Professor, Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan, China. 155 Li-nong St, Sec, 2, Peitou, Taipei 11221, Taiwan, China. cychan@ym.edu.tw
Telephone: +886-2-28211699 Fax: +886-2-28202190
Received: June 7, 2005
Revised: June 12, 2005
Accepted: June 26, 2005
Published online: February 14, 2006
Abstract

Pyogenic liver abscesses usually occur in association with a variety of diseases. Rarely, liver abscess has been reported as the presenting manifestation of colonic tubulovillous adenoma. We report two cases of pyogenic liver abscess without hepatobiliary disease or other obvious etiologies except that one had a history of diabetes mellitus (DM). The pathogen in the patient with DM was Klebsiella pneumonia (KP). In both of the patients, ileus developed about two to three weeks after the diagnosis of liver abscess. Colonoscopy revealed large polypoid tumors with pathological findings of tubulovillous adenoma in both cases. Two lessons were learned from these two cases: (1) an underlying cause should be aggressively investigated in patients with cryptogenic liver abscess; (2) DM could be one of the etiologies but not necessarily the only cause of KP liver abscess.

Keywords: Pyogenic liver abscess; Klebsiella pneumonia; Colonic tubulovillous adenoma