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Metastatic colorectacal carcinoma, associated with pyogenic liver abscess

Atanas Lisnichkov, Vassil Bozhkov, Plamen Chernopolsky, Ilko Plachkov, Todor Ivanov, Rossen Madjov

Abstract

Introduction: A liver abscess represents capsulated purulent focus in the liver parenchyma, due to bacterial, fungal or parasite invasion. In the recent years their frequency rate related to malignant diseases has increased, including abscesses in liver metastases.

 Aim: We present four cases of metastatic colorectacal carcinoma, associated with pyogenic liver abscess, which were treated in the Second Department of Surgery, St. Marina University Hospital, Varna.

Results:  We registered synchronous metastases and in two patients and the remaining two had metachronous metastases. The average age of our patients was 60 years (range 45-80). The patients were operated on and the following interventions were performed – in one - segmentectomy; in two - liver resection with right hemicolectomy; in one - incision, biopsy and drainage; and in one – percutaneous drainage. We established the following systemic complications: pleural effusion in one patient, in one – arrhythmia, subphrenic abscess – in two patients.  The bacterial strains showed K. pneumoniae  in one patient, two – sterile and in one S. epidermidis.

DiscussionIn the recent years a lasting tendency of increasing of the frequency rate of malignant diseases of the GIT has been observed.  The liver abscesses complicating a malignant disease can be treated like an abscess due to benign pathology – via aspiration, drainage and antimicrobial therapy.  Surgical treatment is applied in larger (more than 5 cm) abscesses or with colorectal cancer. The prognosis in these cases is unfavorable due to the malignant diseases and the higher frequency rate of the septic complications.


Keywords

metastases, colorectal cancer, live metastases, abscess, liver abscess

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DOI: http://dx.doi.org/10.14748/ssm.v51i2.6066

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About The Authors

Atanas Lisnichkov
Medical University of Varna
Bulgaria

Department of Surgery, Faculty of Medicine;

Second Clinic of Surgery, St. Marina University Hospital, Varna

Vassil Bozhkov
Medical University of Varna
Bulgaria

Department of Surgery, Faculty of Medicine;

Second Clinic of Surgery, St. Marina University Hospital, Varna

Plamen Chernopolsky
Medical University of Varna
Bulgaria

Department of Surgery, Faculty of Medicine;

Second Clinic of Surgery, St. Marina University Hospital, Varna

Ilko Plachkov
Medical University of Varna
Bulgaria

Department of Surgery, Faculty of Medicine;

Second Clinic of Surgery, St. Marina University Hospital, Varna

Todor Ivanov
Medical University of Varna
Bulgaria

Department of Surgery, Faculty of Medicine;

Second Clinic of Surgery, St. Marina University Hospital, Varna

Rossen Madjov
Medical University of Varna
Bulgaria

Department of Surgery, Faculty of Medicine;

Second Clinic of Surgery, St. Marina University Hospital, Varna

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