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. 2019 May 15;5(1):79.
doi: 10.1186/s40792-019-0639-0.

Liver abscess caused by fish bone perforation of stomach wall treated by laparoscopic surgery: a case report

Tomoaki Bekki  1 , Nobuaki Fujikuni  2 , Kazuaki Tanabe  3 , Hironobu Amano  1   3 , Toshio Noriyuki  1   3 , Masahiro Nakahara  1
Affiliations

Liver abscess caused by fish bone perforation of stomach wall treated by laparoscopic surgery: a case report

Tomoaki Bekki et al. Surg Case Rep. .

Abstract

Background: Formation of a liver abscess due to gastrointestinal perforation by a foreign body is rare. In addition, there are few case reports on laparoscopic surgical treatment of a liver abscess caused by perforation of the gastrointestinal tract by a foreign body.

Case presentation: A 51-year-old man visited our hospital because of fever and anorexia. There were no physical findings except for fever. He had no comorbidities or surgical history. Laboratory tests showed increased inflammatory marker and liver enzyme levels. Abdominal ultrasonography showed a hypoechoic lesion in the left lobe of the liver. Abdominal contrast-enhanced computed tomography revealed an air-containing abscess in the left side of the liver and a high-density linear object. We diagnosed a liver abscess secondary to stomach perforation by a foreign body. Emergency laparoscopic surgery identified a fish bone in the abscess that formed between the stomach and liver. We succeeded in removing the fish bone laparoscopically. The patient was discharged without any postoperative complications on day 11.

Conclusions: A liver abscess secondary to perforation of the gastrointestinal tract by a foreign body usually requires surgical treatment. Foreign body removal is important to prevent recurrence of liver abscess. In cases with the foreign body located at the liver margin, a laparoscopic approach to the abscess is very useful.

Keywords: Fish bone; Laparoscopic surgery; Liver abscess; Perforation of gastrointestinal tract.

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Conflict of interest statement

Ethics approval and consent to participate

Not applicable.

Consent for publication

This patient consented to the reporting of this case in a scientific publication.

Competing interests

The authors declare that they have no competing interests.

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Figures

Fig. 1
Fig. 1
Abdominal ultrasonography findings. A hypoechoic lesion with an irregular margin (white arrow) was located in the left lobe of the liver
Fig. 2
Fig. 2
Abdominal contrast-enhanced computed tomography findings. a A lesion with coexisting low- and high-density areas (black arrow) was found in the left lobe of the liver. b A hyperdense linear body (black arrow) was found in the liver abscess.
Fig. 3
Fig. 3
Intraoperative findings. a Adhesions (black arrow) formed between the liver and reticulum. b Pus leakage from the adhesions between the liver and reticulum. c Fish bone (black arrow) embedded in the reticulum. d Fish bone removed successfully with laparoscopic surgery
Fig. 4
Fig. 4
Postoperative abdominal ultrasonography findings. The abscess (white arrow) became smaller
See this image and copyright information in PMC

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