Liver abscess due to the penetration of an ingested foreign body migrated to the afferent loop blind end after Roux-en Y reconstruction

Abstract

A 71-year old man with right hypochondriac pain was referred to our hospital for suspicion of liver abscess. Enhanced abdominal CT showed a 40 mm liver abscess with a needle-like structure penetrating the intestinal wall to the liver. We suspected that the ingested foreign body had penetrated the afferent loop of Roux-en Y reconstruction and caused liver abscess. We performed double-balloon endoscopy (DBE) and succeeded in removing the foreign body; bamboo skewer. We administrated antibiotics and performed percutaneous abscess drainage, and then he became afebrile. There are no reports of liver abscess due to the penetration of an ingested foreign body migrated to the afferent loop blind end. In this case, DBE was effective in removing a foreign body in a postoperative patient. We must consider the possibility of unexpected movement of ingested foreign body in a patient with surgically altered gastrointestinal anatomy.