“…Although acute appendicitis is a common emergency disease (7%) [8] , appendicitis with pyogenic liver abscess is rare, with an estimated incidence of less than 0.03% [1] . In most cases, liver abscess metachronously occurs after the start of treatment for a perforated, gangrenous, or phlegmonous appendicitis [2] , [9] , [10] . In a previous report, liver abscess was caused by organisms via the following three major routes: the biliary tract (60%), portal vein (6%), and hepatic artery (10%) [11] .…”