Management of Fish Bone-Induced Liver Abscess with Foreign Body Left In Situ

Ryan Burkholder,Hrishikesh Samant

doi:10.1155/2019/9075198

Ryan Burkholder, Hrishikesh Samant

Open Access

https://doi.org/10.1155/2019/9075198

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Abstract

Pyogenic liver abscess, having experienced an evolving pathogenesis over the years, still remains a serious problem with significant morbidity. Iatrogenic and ascending biliary infections are the most common known etiologies for hepatic abscess. Here we report an interesting case of an elderly lady admitted with abdominal pain due to a pyogenic liver abscess in the left liver lobe which was attributed to perforation by an ingested fish bone. The authors also reviewed literature for management for this rare case as there are no standard guidelines. Our patient was successfully treated with antibiotics and percutaneous drainage with foreign body left in situ.

Highlights

Pyogenic liver abscess is becoming a rare cause of abdominal pain with very low estimated annual incidence at 2.3 cases per 100,000 people [1]
The authors describe a case of a penetration of fish bone from stomach directly into the liver forming a pyogenic liver abscess which successfully responded to drainage and antibiotics
Various complications of foreign body penetration through the GI tract are reviewed in the literature, few hepatic abscesses due to silent migration of a fish bone have been reported in the Western world

Summary

Introduction

Pyogenic liver abscess is becoming a rare cause of abdominal pain with very low estimated annual incidence at 2.3 cases per 100,000 people [1]. Biliary tract disease is still the most common risk factor for development of liver abscess [2]. While accidental ingestion of sharp foreign bodies is common, perforations by foreign body are very rare nowadays due to advances in upper gastrointestinal endoscopic techniques and availability. The authors describe a case of a penetration of fish bone from stomach directly into the liver forming a pyogenic liver abscess which successfully responded to drainage and antibiotics. Various complications of foreign body penetration through the GI tract are reviewed in the literature, few hepatic abscesses due to silent migration of a fish bone have been reported in the Western world

Case Report

Discussion

Findings

Conflicts of Interest