title: Should colonoscopy be performed in patients with cryptogenic liver abscess?
abstract: OBJECTIVE
  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.
authors.affiliation: Department of Internal Medicine, Eulji University Hospital, Daejeon, Republic of Korea.
authors.forename: Hyun Cheol
authors.initials: HC
authors.lastname: Koo
authors.forename: Young Seok
authors.initials: YS
authors.lastname: Kim
authors.forename: Sang Gyune
authors.initials: SG
authors.lastname: Kim
authors.forename: Jae Woong
authors.initials: JW
authors.lastname: Tae
authors.forename: Bong Min
authors.initials: BM
authors.lastname: Ko
authors.forename: Tae Il
authors.initials: TI
authors.lastname: Lee
authors.forename: Seung Won
authors.initials: SW
authors.lastname: Jeong
authors.forename: Jae Young
authors.initials: JY
authors.lastname: Jang
authors.forename: Hong Soo
authors.initials: HS
authors.lastname: Kim
authors.forename: Sae Hwan
authors.initials: SH
authors.lastname: Lee
authors.forename: Boo Sung
authors.initials: BS
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003110:Colonic Neoplasms / Q000150:complications* / Q000175:diagnosis*; D003113:Colonoscopy; D005260:Female; D006801:Humans; D008100:Liver Abscess / Q000150:complications*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies