title: The Prevalence of Colonic Neoplasm in Cryptogenic Pyogenic Liver Abscess: A Prospectively Enrolled Cross-sectional Study.
abstract: OBJECTIVE
  Several studies suggest that pyogenic liver abscess (PLA) is associated with colon neoplasm. A colonoscopic exam for cryptogenic PLA might detect a hidden colon neoplasm, through which intestinal flora can be transmitted into the liver. However, there are no prospectively enrolled cross-sectional data for colonic neoplasm in cryptogenic PLA.
  
  
  METHODS
  Patients with PLA were prospectively enrolled from two university hospitals. Among them, all the patients with cryptogenic PLA were recommended for colonoscopic exam to check for colonic neoplasm.
  
  
  RESULTS
  One hundred eighty-three patients with PLA were enrolled in the study for 22 months. One hundred and one (55.2%) patients did not have a definite cause of liver abscess at initial evaluation. The median diameter of the largest lesion was 5.7 cm (1.0-14.0 cm), and 74.3% of the patients were treated by percutaneous abscess drainage. Ninety-one percent of the patients who had an identified pathogen yielded Klebsiella. Sixty-two patients underwent colonoscopic exams, and no one had a colonic cancer, one had an adenomatous polyp with high grade dysplasia (1.6%), and 27 had adenomatous polyps with low grade dysplasia (43.5%; 41.0% in male and 43.5% in female). Of fifty patients who underwent an esophagogastroduodenoscopic exam, nine had gastric ulcers, one had an esophageal ulcer, and one had hemorrhagic gastritis.
  
  
  CONCLUSIONS
  The prevalence of colonic neoplasm among the patients with cryptogenic PLA was not as high as that in previous studies. Further well-designed, large-scale studies are required to assess the association of the colon neoplasm and cryptogenic PLA.
authors: Department of Internal Medicine, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea.
authors: Nae Yun
authors: NY
authors: Heo
authors: Department of Internal Medicine, Pusan National University College of Medicine, Busan, Korea.|Liver Center, Pusan National University Yangsan Hospital, Yangsan, Korea.
authors: Young Mi
authors: YM
authors: Hong
authors: Department of Internal Medicine, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea.
authors: Tae Oh
authors: TO
authors: Kim
authors: Department of Internal Medicine, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea.
authors: Young Soo
authors: YS
authors: Moon
authors: Department of Internal Medicine, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea.
authors: Sung Yeun
authors: SY
authors: Yang
authors: Department of Internal Medicine, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea.
authors: Seung Ha
authors: SH
authors: Park
authors: Department of Internal Medicine, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea.
authors: Jongha
authors: J
authors: Park
authors: Department of Internal Medicine, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea.
authors: Joon Hyuk
authors: JH
authors: Choi
authors: Department of Internal Medicine, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea.
authors: Sung Min
authors: SM
authors: Kim
authors: Department of Internal Medicine, Pusan National University College of Medicine, Busan, Korea.|Liver Center, Pusan National University Yangsan Hospital, Yangsan, Korea.
authors: Ki Tae
authors: KT
authors: Yoon
authors: Department of Internal Medicine, Pusan National University College of Medicine, Busan, Korea.|Liver Center, Pusan National University Yangsan Hospital, Yangsan, Korea.
authors: Mong
authors: M
authors: Cho
authors: Department of Pharmacology, Inje University College of Medicine, Busan, Korea.|Clinical Trial Center, Inje University Busan Paik Hosptial, Busan, Korea.
authors: Minkyung
authors: M
authors: Oh
mesh_terms: D000236:Adenoma / Q000175:diagnosis / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003110:Colonic Neoplasms / Q000175:diagnosis* / Q000453:epidemiology; D003111:Colonic Polyps / Q000473:pathology; D003113:Colonoscopy; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007709:Klebsiella / Q000302:isolation & purification; D046290:Liver Abscess, Pyogenic / Q000175:diagnosis* / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D055815:Young Adult
keywords: Colonic neoplasms; Liver abscess, pyogenic; Prevalence