Case Control Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Apr 28, 2017; 23(16): 2948-2956
Published online Apr 28, 2017. doi: 10.3748/wjg.v23.i16.2948
Recent upper gastrointestinal panendoscopy increases the risk of pyogenic liver abscess
Ming-Jen Tsai, Chin-Li Lu, Ying C Huang, Chung Hsien Liu, Wan-Ting Huang, Kai-Yuan Cheng, Solomon Chih-Cheng Chen
Ming-Jen Tsai, Ying C Huang, Chung Hsien Liu, Kai-Yuan Cheng, Department of Emergency Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi 60002, Taiwan
Ming-Jen Tsai, Department of Sports Management, Chia Nan University of Pharmacy and Science, Tainan 71710, Taiwan
Chin-Li Lu, Department of Public Health, College of Medicine, National Cheng-Kung University, Tainan 70101, Taiwan
Ying C Huang, Department of Emergency Medicine, Medical Center and School of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
Wan-Ting Huang, Department of Medical Research, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi 60002, Taiwan
Solomon Chih-Cheng Chen, Heng Chun Christian Hospital, Pingtung County 946, Taiwan
Solomon Chih-Cheng Chen, Department of Pediatrics, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan
Author contributions: Tsai MJ and Cheng KY contributed equally to this study and shared the first authorship; Tsai MJ, Cheng KY and Chen SCC conceptualized and designed the research; Chen SCC applied for the dataset from the National Health Research Institute; Lu CL and Huang WT collected and analyzed the data; all authors discussed the results; Tsai MJ and Cheng KY drafted the manuscript; Huang YC and Chen SCC critically reviewed the paper; all authors discussed the feasibility of the research and the results, and approved the final manuscript.
Institutional review board statement: The Institutional Review Board of Ditmanson Medical Foundation Chia-Yi Christian Hospital has approved this study (CYCH-IRB No. 104034).
Informed consent statement: No written informed consent is obtained since all the data have been de-identified before analysis.
Conflict-of-interest statement: The authors declare no conflicts of interest.
Data sharing statement: Dataset if available from the corresponding author at Solomon.ccc@gmail.com. No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Solomon Chih-Cheng Chen, MD, MS, PhD, Heng Chun Christian Hospital, No. 21, Hengxi Road, Hengchun Township, Pingtung County 946, Taiwan. solomon.ccc@gmail.com
Telephone: +886-928901217 Fax: +886-88880111
Received: January 5, 2017
Peer-review started: January 8, 2017
First decision: January 19, 2017
Revised: February 1, 2017
Accepted: March 30, 2017
Article in press: March 30, 2017
Published online: April 28, 2017
Processing time: 112 Days and 20.3 Hours
Core Tip

Core tip: A pyogenic liver abscess (PLA) is a potential lethal disease with known pathogeneses, including biliary tract infection and portal venous bacterial spreading. Gastrointestinal (GI) endoscopies are common procedures that sometimes have complications of mucosa trauma, local infection, and bacteremia. The relationship between GI endoscopy and subsequent PLA has not yet been documented. This large nested case-control study has shown a significant association between a recent upper GI panendoscopy and increased risk of PLA, though a lower GI endoscopy and the invasive procedure itself of a GI endoscopy did not increase the risk of PLA. Furthermore, patients with diabetes mellitus, end-stage renal disease, liver cirrhosis, biliary tract infection, and GI malignancies could also have a higher risk of PLA. In summary, clinical physician should not ignore the risk of development of PLA after patients receiving an upper GI panendoscopy, especially in those with diabetes mellitus, end-stage renal disease, liver cirrhosis, biliary tract infection, and GI malignancies.