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Case Reports
. 2022 May 26;10(15):5012-5017.
doi: 10.12998/wjcc.v10.i15.5012.

Gastric heterotopia of colon found cancer workup in liver abscess: A case report

Jun Gi Park  1 , Jeong Ill Suh  2 , Yeo Un Kim  1
Affiliations
Case Reports

Gastric heterotopia of colon found cancer workup in liver abscess: A case report

Jun Gi Park et al. World J Clin Cases. .

Abstract

Background: Recently reported cases of pyogenic liver abscess associated with colonic cancer in the absence of underlying disease, have included a small number of cases of gastric heterotopia (GHT). GHT is a congenital anomaly composed of ectopic gastric mucosa and can occur anywhere in the gastrointestinal tract but is more frequently encountered in the cervical esophagus. However, it is rarely observed in colon. Furthermore, most reported cases of GHT of the colon involved the rectum, and GHT involving the colon proximal to the rectum is rare.

Case summary: An 83-year-old male patient presented with fever and a diagnosis of pyogenic liver abscess. Colonoscopy was performed for colon cancer workup and revealed a 1.0 cm sized polyp at the transverse colon. The polyp was removed by endoscopic mucosal resection by monopolar electrocauterization using a snare. Pathological examination revealed GHT. After administering intravenous antibiotics, the patient recovered well.

Conclusion: GHT in the colon could affect the development of pyogenic liver abscess by enabling hematogenous propagation of Klebsiella pneumoniae through mucosal damage. However, more study is needed due to the lack of cases.

Keywords: Case report; Colon; Gastric heterotopia; Liver abscess.

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Conflict of interest statement

Conflict-of-interest statement: The authors have no conflict of interest to declare.

Figures

Figure 1
Figure 1
Abdominal computed tomography images showing the pyogenic liver abscess. A and B: Axial and coronal images showing a ca. 2 cm × 2.5 cm sized, ill-defined, low attenuation nodular lesion in liver segment 6.
Figure 2
Figure 2
Colonoscopy during cancer workup. A: Colonoscopy revealed about 1.0 cm sized, semi-pedunculated polyp at the transverse colon; B: The polyp was removed by endoscopic mucosa resection by monopolar electrocauterization using a snare; C: The polyp was successfully removed.
Figure 3
Figure 3
Histology showed that the excised tissue was consistent with heterotopic gastric tissue with intestinal metaplasia, fibrosis, and vascular and nervous tissue proliferation. HE (× 100).
Figure 4
Figure 4
Follow-up abdominal computed tomography after antibiotic treatment for 33 d showing resolution of the pyogenic liver abscess. A and B: Axial and coronal images showing resolution of the focal ill-defined low attenuation in liver segment 6.
See this image and copyright information in PMC

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