Fish bone migration: an unusual cause of liver abscess.

Gastroenterology and Hepatology Department, King Fahad Medical City, Riyadh, Saudi Arabia.
Case Reports 01/2012; 2012. DOI:10.1136/bcr.09.2011.4838
Source: PubMed

ABSTRACT Treating a pyogenic liver abscess is a therapeutic challenge when a patient presents with atypical symptoms. One of the rare causes of treatment failure of these abscesses is the unrecognised migration of a foreign body from the gastrointestinal tract. The authors describe a pyogenic liver abscess in a 45-year-old male who presented with a 10 day history of fever, and abdominal pain. A CT scan of the abdomen revealed a needle-like foreign body in the liver. At operation a 2.5 cm fish bone was extracted from the liver. Subsequently, his feverish symptoms disappeared, and he has remained well in the ensuing 3 month postoperative period. Fish bone-induced liver abscess is discussed in this brief report.

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    ABSTRACT: Perforation of the gastrointestinal tract by ingested foreign bodies is rare; the diagnosis of pyogenic liver abscess resulting from such perforations is usually made at post-mortem. We present a case of perforation of the gut, due to an ingested dental plate, with a resultant pyogenic liver abscess, which presented as a pyrexia of unknown origin.
    Postgraduate Medical Journal 08/1983; 59(693):455-6. · 1.61 Impact Factor
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    ABSTRACT: A prospective study was performed on 358 patients to examine the diagnosis, management, and natural history of fish bone ingestion. All patients admitted with the complaint had a thorough oral examination. Flexible endoscopy under local pharyngeal anesthesia would be performed on patients with negative findings. Of 117 fish bones encountered, 103 were removed (direct removal, 21; endoscopic removal, 82) and 12 were inadvertently dislodged. One was missed and the other one necessitated removal with rigid laryngoesophagoscopy under general anesthesia. Morbidity (1%) occurred in patients with triangular bones in the hypopharynx, resulting in one mucosal tear and two lengthy procedures. Mean hospital stay was 7 hours. Prediction of the presence of fish bones by symptoms and radiograph was poor. The location of symptoms, however, was useful in guiding the endoscopist to the site of lodgment. Of patients who refused endoscopy, only one (2.8%) developed retropharyngeal abscess. As compared to those who received endoscopy, 31.8% had fish bones detected. As the yield of fish bone detected was also inversely related to the duration of symptoms, we strongly suspect that most of the unremoved fish bones would be dislodged and passed. However, because of the serious potential complication from fish bone ingestion, we believe that a combination of oral examination followed by flexible endoscopy is indicated in all patients. When triangular bones in the hypopharynx are encountered, rigid laryngoesophagoscopy should be considered. This protocol had safely and effectively dealt with the present series of patients.
    Annals of Surgery 05/1990; 211(4):459-62. · 6.33 Impact Factor
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    ABSTRACT: Two uncommon cases of foreign body (a wooden clothespin and a toothpick) perforation of the gur with associated pyogenic liver abscesses are presented. These cases illustrate the difficulties of preoperative diagnosis. The lack of history of ingestion of foreign bodies, variable clinical presentation of the conditions and radiolucent natures of the foreign bodies all play a role in impeding the diagnosis preoperatively. This report emphasizes the role of ultrasound and computed tomographic scan in evaluating similar cases. Any patient with known risk factors for ingestion of foreign body should arouse suspicion and be investigated further.
    Canadian journal of gastroenterology = Journal canadien de gastroenterologie 11(5):445-8. · 1.53 Impact Factor


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Dec 12, 2012

Ibrahim Masoodi