A case report of a recurrent abscess secondary to fish bone penetration of the ileum

Abstract

A 62-year-old man with right upper abdominal swelling was admitted to our hospital. Abdominal computed tomography (CT) revealed a hepatic abscess. He was treated with percutaneous abscess drainage along with antibiotic therapy. After the treatment, the patient was discharged. However, we failed to notice a fish bone, which had been revealed in the CT scan. One year and five months later, the same patient presented with right lower abdominal pain and vomiting. Abdominal CT showed a subcutaneous abdominal abscess of the right lower abdomen, with the same fish bone penetrating out of the ileum. Accordingly, the patient was subjected to surgical abscess drainage, and the fish bone was successfully removed. The findings of this case suggest that the source of infection of the hepatic abscess should be identified, searching not only the nearby organs but also the distally located organs, including the lower gastrointestinal tract. The findings also suggest that the surgical removal of a fish bone should be considered.