A Case of Hepatic Abscess Treated by Laparoscopic Removal of a Fish Bone Penetrating through the Stomach

Abstract

We report a case of hepatic abscess caused by a fish bone penetrating the gastric wall. A 41-year-old man presented with a 2-week history of low-grade fever and upper abdominal pain. Abdominal USG and CT showed strong internal needle-like echoes, and abscess, respectively, in the lateral segment of the liver, and the patient was started on antibiotics. Since the hepatic abscess was regarded as being secondary to a foreign body, that is, a fish bone that had penetrated through the stomach, laparoscopic removal of the fish bone was performed. Simultaneously, we used intraoperative USG in order to locate the fish bone and confirm the remnants. The postoperative course was good. When the general condition is stable after conservative therapy, an elective laparoscopic approach can be chosen to remove a foreign body. While laparoscopy surgery is less invasive and provides magnified viewing, intraoperative palpation is difficult. Alternatively, intraoperative USG may be a useful option for checking foreign objects accurately.