Please wait a minute...
Shopping Cart Email List Chinese
Advanced Search Fig/Tab
Frontiers of Medicine

ISSN 2095-0217

ISSN 2095-0225(Online)

CN 11-5983/R

Postal Subscription Code 80-967

2018 Impact Factor: 1.847

Featured Articles  |  Most Downloaded  |  Most Reading
Online Submission Subscribe to Our RSS Content Feed
Front Med    2011, Vol. 5 Issue (4) : 434-437    https://doi.org/10.1007/s11684-011-0157-3
CASE REPORT
Pyogenic liver abscess as initial presentation in locally advanced right colon cancer invading the liver, gallbladder, and duodenum
Kai Qu1, Chang Liu1(), Aasef M A Mansoor2, Bo Wang1, Jincai Chen3, Liang Yu1, Yi Lv1
1. Department of Hepatobiliary Surgery, the First Affiliated Hospital, School of Medicine, Xi’an Jiaotong University, Xi’an 710061, China; 2. School of Medicine, Xi’an Jiaotong University, Xi’an 710061, China; 3. Department of General Surgery, the First Affiliated Hospital, ?School of Medicine, Xi’an Jiaotong University, Xi’an 710061, China
 Download: PDF(371 KB)   HTML
 Export: BibTeX | EndNote | Reference Manager | ProCite | RefWorks
Abstract

Locally advanced colorectal cancer complicated with adjacent organic invasion may remain confined to the local area with minimal metastasis. In the present paper, we report on a patient with advanced right colon cancer, including liver, gallbladder, and duodenal invasion behind the scene of liver abscess. En bloc resection was performed on the patient, with right-hemicolectomy, cholecystectomy, partial duodental resection, and hepatectomy. Postoperative management was administered, including nutritional support in the early postoperative period, effective anti-infection treatment, and adjuvant chemotherapy (FOLFOX4). The patient survived for 16 months after the operation. Common clinical manifestations of colorectal cancer were digestive symptoms and changes in defecation. However, the clinical manifestation of locally advanced colon cancer was extremely complicated. Extended or multivisceral resection may offer patients a chance to survive an acute crisis and allow for treatment with adjuvant therapy.
Keywords liver abscess      locally advanced colon cancer      multiorganic invasion     
Corresponding Author(s): Liu Chang,Email:eyrechang@126.com   
Issue Date: 05 December 2011
 Cite this article:   
Kai Qu,Chang Liu,Aasef M A Mansoor, et al. Pyogenic liver abscess as initial presentation in locally advanced right colon cancer invading the liver, gallbladder, and duodenum[J]. Front Med, 2011, 5(4): 434-437.
 URL:  
https://academic.hep.com.cn/fmd/EN/10.1007/s11684-011-0157-3
https://academic.hep.com.cn/fmd/EN/Y2011/V5/I4/434
Fig.1  Transverse CT scan demonstrated a large cavity within the segment V of the hepatic parenchyma (7.4 cm × 8.9 cm × 9.0 cm in size, thick arrow) with air (thin arrow). CT morphological features facilitated the diagnosis of the abscess. No other lesions were found in the liver.
Fig.2  Colography demonstrated a fistula connecting the hepatic flexure of the colon with the liver abscess cavity (arrow).
Fig.3  Abscess boundaries after drainage included the liver (L), gallbladder (G), duodenum (D), colon (C), and the cavity of abscess (A).
Fig.4  Results of the histological examination. (A) Tissue of the duodenal resection showed a nest of adenocarcinoma (, hematoxylin and eosin stain × 40). (B) The magnified image depicts pale watery cytoplasm and clear nuclei in cells, both of which are consistent with adenocarcinoma (, hematoxylin and eosin stain × 400).
Fig.5  The operative diagram. (A) Anatomical relationship between the colon tumor and adjacent organs. (B) Complete resection including right-hemicolectomy (I), partial duodenal resection (II), partial hepatectomy (III), gastrojejunostomy (IV), mucous fistula (V), and ileostomy (VI). Three drainage tubes, including abscess cavity drainage tube (1), T-tube (2), and duodenal decompression drainage tube (3), were set.
1 Cress RD, Morris C, Ellison GL, Goodman MT. Secular changes in colorectal cancer incidence by subsite, stage at diagnosis, and race/ethnicity, 1992-2001. Cancer 2006; 107(Suppl 5): 1142–1152
doi: 10.1002/cncr.22011 pmid:16835912
2 Center MM, Jemal A, Ward E. International trends in colorectal cancer incidence rates. Cancer Epidemiol Biomarkers Prev 2009; 18(6): 1688–1694
doi: 10.1158/1055-9965.EPI-09-0090 pmid:19505900
3 Yang L, Li L, Chen Y, Parkin DM. Cancer incidence and mortality estimates and prediction for year 2000 and 2005 in China. Chin J Health Stat (Zhongguo Wei Sheng Tong Ji) 2005; 22(4): 218–221 (in Chinese)
4 Stangl R, Altendorf-Hofmann A, Charnley RM, Scheele J. Factors influencing the natural history of colorectal liver metastases. Lancet 1994; 343(8910): 1405–1410
doi: 10.1016/S0140-6736(94)92529-1 pmid:7515134
5 Lopez MJ, Monafo WW. Role of extended resection in the initial treatment of locally advanced colorectal carcinoma. Surgery 1993; 113(4): 365–372
pmid:7681222
6 Curley SA, Evans DB, Ames FC. Resection for cure of carcinoma of the colon directly invading the duodenum or pancreatic head. J Am Coll Surg 1994; 179(5): 587–592
pmid:7952464
7 Teitz S, Guidetti-Sharon A, Manor H, Halevy A. Pyogenic liver abscess: warning indicator of silent colonic cancer. Dis Colon Rectum 1995; 38(11): 1220–1223
doi: 10.1007/BF02048342 pmid:7587769
8 Adelstein BA, Macaskill P, Chan SF, Katelaris PH, Irwig L. Most bowel cancer symptoms do not indicate colorectal cancer and polyps: a systematic review. BMC Gastroenterol 2011; 11(1): 65
doi: 10.1186/1471-230X-11-65 pmid:21624112
9 Koea JB, Conlon K, Paty PB, Guillem JG, Cohen AM. Pancreatic or duodenal resection or both for advanced carcinoma of the right colon. Dis Colon Rectum 2000; 43(4): 460–465
doi: 10.1007/BF02237187 pmid:10789739
10 Ike H, Shimada H, Yamaguchi S, Ichikawa Y, Fujii S, Ohki S. Outcome of total pelvic exenteration for primary rectal cancer. Dis Colon Rectum 2003; 46(4): 474–480
doi: 10.1007/s10350-004-6585-2 pmid:12682540
11 Lehnert T, Methner M, Pollok A, Schaible A, Hinz U, Herfarth C. Multivisceral resection for locally advanced primary colon and rectal cancer: an analysis of prognostic factors in 201 patients. Ann Surg 2002; 235(2): 217–225
doi: 10.1097/00000658-200202000-00009 pmid:11807361
12 Berrospi F, Celis J, Ruiz E, Payet E. En bloc pancreaticoduodenectomy for right colon cancer invading adjacent organs. J Surg Oncol 2002; 79(3): 194–197 , discussion 198
doi: 10.1002/jso.10072 pmid:11870671
13 Kapoor S, Das B, Pal S, Sahni P, Chattopadhyay TK. En bloc resection of right-sided colonic adenocarcinoma with adjacent organ invasion. Int J Colorectal Dis 2006; 21(3): 265–268
doi: 10.1007/s00384-005-0756-z pmid:15940511
14 Nakafusa Y, Tanaka T, Tanaka M, Kitajima Y, Sato S, Miyazaki K. Comparison of multivisceral resection and standard operation for locally advanced colorectal cancer: analysis of prognostic factors for short-term and long-term outcome. Dis Colon Rectum 2004;47(12): 2055–2063
doi: 10.1007/s10350-004-0716-7 pmid:15657654
[1] Jing LI, Ying FU, Ji-Yao WANG, Chuan-Tao TU, Xi-Zhong SHEN, Lei LI, Wei JIANG. Early diagnosis and therapeutic choice of Klebsiella pneumoniae liver abscess[J]. Front Med Chin, 2010, 4(3): 308-316.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed