A Case of Hepatic Abscess Caused by Penetration of a Cod Bone

Abstract

An 83-year-old woman visited us with the chief complaint of malaise. She also had fever. Laboratory data showed high levels of the acute inflammatory markers. Ultrasonography (US) and computed tomography (CT) showed a hepatic abscess with a sharp linear density in the abscess extending from the stomach. On detailed questioning, she revealed that she had eaten boiled fish 9 days earlier. Percutaneous transhepatic drainage was performed, however, the inflammation persisted. We decided to perform laparotomy, which revealed a 4.5-cm-long fish bone in the left lateral segment of the liver extending into the omentum minor. The foreign body was removed, and the abscess was drained. The postoperative course was uneventful. We reviewed the literature for reports of hepatic abscess caused by a fish bone. In most reported cases, removal of the bone was achieved by open or laparoscopic surgery. Ingestion of a foreign body is easily forgotten. Both US and CT are helpful for diagnosis. Clinicians need to recognize that ingested foreign bodies can even cause a liver abscess.