Pyogenic liver abscess secondary to asymptomatic sigmoid diverticulitis

Area of Science:

• Gastroenterology
• Hepatology
• Infectious Diseases

Background:

• Pyogenic liver abscesses can arise from various sources, often presenting with non-specific symptoms.
• Sigmoid diverticulitis is a common condition, but its association with liver abscesses is infrequent.
• Asymptomatic presentations of sigmoid diverticulitis can delay diagnosis and treatment.

Observation:

• A patient presented with multiple pyogenic abscesses in both liver lobes.
• The liver abscesses were found to be secondary to previously undiagnosed, asymptomatic sigmoid diverticulitis.
• This represents a rare clinical presentation linking gastrointestinal pathology to hepatic infection.

Findings:

• The study identifies a rare but significant association between asymptomatic sigmoid diverticulitis and pyogenic liver abscesses.
• Diagnostic imaging, specifically barium enema, is crucial for identifying the source in cases of pyogenic liver abscess of unknown etiology.
• Early detection of sigmoid diverticulitis can prevent serious complications like liver abscess formation.

Implications:

• Clinicians should consider sigmoid diverticulitis in the differential diagnosis of pyogenic liver abscesses, even in the absence of typical gastrointestinal symptoms.
• Implementing barium enema in the workup for pyogenic liver abscesses of unknown origin may improve diagnostic yield.
• This case underscores the importance of thorough investigation for underlying gastrointestinal pathology in patients with cryptogenic liver abscesses.