{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T04:55:37Z","timestamp":1790916937675,"version":"4.1.0"},"reference-count":23,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T00:00:00Z","timestamp":1790899200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Pyogenic liver abscess (PLA) is a severe infectious condition that is often associated with an identifiable biliary or gastrointestinal source. Benign colonic lesions are rarely considered during the etiological evaluation of PLA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>\n                      We report the case of a 47-year-old man admitted with febrile diarrhea. Contrast-enhanced computed tomography (CT) demonstrated confluent hepatic abscesses involving segments II, III, and IV, measuring 10\u2005cm\u2009\u00d7\u20099\u2005cm\u2009\u00d7\u20097\u2005cm, without a CT-detectable biliary source. The etiological investigation identified an approximately 2\u2005cm inflammatory sigmoid lesion that was initially considered suspicious for malignancy. Laparoscopic oncologic segmental low sigmoid colectomy was performed because malignancy could not be confidently excluded based on superficial endoscopic biopsies. Histopathological examination confirmed a 1.2\u2005cm submucosal lipoma composed of mature univacuolar adipocytes without cytologic atypia, necrosis, or abscess formation. The colonic wall directly opposite the lipoma showed acute neutrophil-rich inflammation extending from the mesocolic\/subserosal tissues through the muscularis propria, together with focal superficial epithelial abrasion\/erosion of the overlying mucosa and exposure of the lamina propria. Deep or transmural mucosal ulceration, ischemic necrosis, intramural abscess, microorganisms, perforation, and diverticular disease were not demonstrated in the available histopathological sections. Blood cultures were negative. Culture of the hepatic abscess aspirate isolated\n                      <jats:italic>Klebsiella pneumoniae.<\/jats:italic>\n                      The colonic lesion itself was not cultured, and no microbiological or molecular comparison with the hepatic isolate was performed. No phenotypic or molecular testing for a hypervirulent\n                      <jats:italic>K. pneumoniae<\/jats:italic>\n                      phenotype was conducted.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This case describes a possible association between PLA and an inflamed sigmoid submucosal lipoma with focal superficial epithelial abrasion\/erosion. A causal relationship cannot be established from the available evidence. The clinical implication is that colonic evaluation, including colonoscopy when clinically appropriate, may be considered in otherwise unexplained PLA, particularly when no biliary or other common source is identified. This single case does not establish small colonic lipomas as infectious sources of PLA.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1957072","type":"journal-article","created":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T04:37:45Z","timestamp":1790915865000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Possible association of pyogenic liver abscess with an inflamed sigmoid colonic lipoma: a case report and literature review"],"prefix":"10.3389","volume":"13","author":[{"given":"Khaireddine","family":"Dhouioui","sequence":"first","affiliation":[{"name":"Department of Gastrointestinal Surgery, Farhat Hached University Hospital, Faculty of Medicine, University of Sousse","place":["Sousse, Tunisia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed","family":"Abu Awad","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Farhat Hached University Hospital, Faculty of Medicine, University of Sousse","place":["Sousse, Tunisia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed Hedi","family":"Mraidha","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Surgery, Farhat Hached University Hospital, Faculty of Medicine, University of Sousse","place":["Sousse, Tunisia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soumaya","family":"Mrabet","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Farhat Hached University Hospital, Faculty of Medicine, University of Sousse","place":["Sousse, Tunisia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorra","family":"Chiba","sequence":"additional","affiliation":[{"name":"Department of Pathology, Farhat Hached University Hospital, Faculty of Medicine, University of Sousse","place":["Sousse, Tunisia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raida","family":"Harbi","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Farhat Hached University Hospital, Faculty of Medicine, University of Sousse","place":["Sousse, Tunisia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elhem","family":"Ben Jazia","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Farhat Hached University Hospital, Faculty of Medicine, University of Sousse","place":["Sousse, Tunisia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moncef","family":"Mokni","sequence":"additional","affiliation":[{"name":"Department of Pathology, Farhat Hached University Hospital, Faculty of Medicine, University of Sousse","place":["Sousse, Tunisia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabri","family":"Youssef","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Surgery, Farhat Hached University Hospital, Faculty of Medicine, University of Sousse","place":["Sousse, Tunisia"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,10,2]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"600","DOI":"10.1097\/00000658-199605000-00016","article-title":"Pyogenic hepatic abscess. 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