Pyogenic Liver Abscess Secondary to Bowel Perforation by Ingested Fish Bone

Abstract

Accidental ingestion of foreign bodies is a common clinical occurrence in medical practice, but hepatic abscess caused by said ingested foreign bodies is rather uncommon. Pre-operative diagnosis is difficult due to lack of patient awareness of the foreign body as well as non-specific symptoms and imaging findings. We hereby report a rare case of a 68-year-old African male who was admitted with fever and abdominal pain. Further investigation revealed a pyogenic liver abscess caused by an ingested fish bone penetrating the second part of the duodenum, without resolution despite initial antibiotic therapy. Final diagnosis and treatment included a combined endoscopic and surgical approach to remove the fish bone and repair the duodenal perforation along with CT-guided drainage of the abscess by interventional radiology.