Surgery Today

, Volume 29, Issue 9, pp 922–926 | Cite as

Successful treatment of a hepatic abscess that formed secondary to fish bone penetration by percutaneous transhepatic removal of the foreign body: Report of a case

  • Katsuhiko Horii
  • Osamu Yamazaki
  • Mitsuharu Matsuyama
  • Ikko Higaki
  • Shuichi Kawai
  • Yoshihiro Sakaue
Case Reports


We describe herein the case of a hepatic abscess that developed secondary to fish bone penetration which was successfully treated without laparotomy. A 61-year-old man was admitted to our hospital with a high fever that had persisted for 2 weeks in spite of medication. Abdominal ultrasonography (AUS) and computed tomography (CT) of the abdomen revealed a hepatic abscess with a linear calcified foreign body and gas. Percutaneous abscess drainage was performed under ultrasonographic guidance. After drainage, the patient became afebrile, and AUS and CT findings demonstrated that the abscess cavity had decreased in size, but still contained the foreign body. Under ultrasonographic guidance and fluoroscopy, we inserted endoscopic forceps into the sinus tract and succeeded in removing the foreign body from the liver. It was found to be a fish bone that was 2.8 cm long and 0.3 cm wide.

Key Words

hepatic abscess fish bone penetration percutaneous transhepatic removal 


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  1. 1.
    Strauss JE, Balthazar EJ, Naidich DP (1985) Jejunal perforation by a toothpick: CT demonstration. J Comput Assist Tomogr 9:812–814CrossRefPubMedGoogle Scholar
  2. 2.
    McCanse DE, Kurchin A, Hinshaw JR (1981) Gastrointestinal foreign bodies. Am J Surg 142:335–337CrossRefPubMedGoogle Scholar
  3. 3.
    Maleki M, Evans WE (1970) Foreign-body perforation of the intestinal tract. Report of 12 cases and review of the literature. Arch Surg 101:475–477PubMedGoogle Scholar
  4. 4.
    Gary JN, Raymond BK (1984) Liver abscess following ingestion of a foreign body. Pediatr Infect Dis 3:342–344CrossRefGoogle Scholar
  5. 5.
    Abel RM, Fischer JE, Hendren WH (1971) Penetration of the alimentary tract by a foreign body with migration to the liver. Arch Surg 102:227–228PubMedGoogle Scholar
  6. 6.
    Berk RN, Reit RJ (1971) Intra-abdominal chicken-bone abscess. Diagn Radiol 101:311–313Google Scholar
  7. 7.
    Rafizadeh F, Silver H, Fieber S (1981) Pyogenic liver abscess secondary to a toothpick penetrating the gastrointestinal tract. J Med Soc New Jersey 78:377–378PubMedGoogle Scholar
  8. 8.
    Tsuboi K, Nakajima Y, Yamamoto S (1981) A case of an intrahepatic fish bone penetration—possibility of the preoperative diagnosis by CT scan. Arch Jpn Chir 50:899–903Google Scholar
  9. 9.
    Bloch DB (1984) Venturesome toothpick—a continuing source of pyogenic hepatic abscess. JAMA 252:797–798CrossRefPubMedGoogle Scholar
  10. 10.
    Pedersen VM, Geerdsen JP, Bartholdy J (1986) Foreign body perforation of the gastrointestinal tract with formation of liver abscess. Ann Chir Gynae 75:245–246Google Scholar
  11. 11.
    Gonzalez JG, Gonzalez RR, Patino JV (1988) CT finding in gastrointestinal perforation by ingested fish bones. J Comput Assist Tomogr 12:88–90CrossRefPubMedGoogle Scholar
  12. 12.
    Iwasa M, Sekoguti T, Wada K (1988) Granulomatous abscess of the liver—a case and review of the Japanese literature (in Japanese). Nippon Rinshou Geka Gakkaisi 49:2382–2387Google Scholar
  13. 13.
    Dugger K, Lebby T, Brus M (1990) Hepatic abscess resulting from gastric perforation of a foreign object. Am J Emerg Med 8:323–325CrossRefPubMedGoogle Scholar
  14. 14.
    Masunaga S, Abe M, Imura T (1991) Hepatic abscess secondary to a fishbone penetrating the gastric wall: CT demonstration. Comp Med Imag Graph 15:113–116CrossRefGoogle Scholar
  15. 15.
    Chen SM, Shen MT, Lo GH (1993) Duodenal perforation with live abscess caused by ingestion of a chicken bone. Chin J Gastroenterol 10:312–319Google Scholar
  16. 16.
    Matsuzaki H, Kikuchi T, Ichinose M (1995) A case of granulomatous abscess of the liver due to penetration by fish bone (in Japanese). Nippon Shoukaki Geka Gakkaisi 28:1095–1099Google Scholar

Copyright information

© Springer-Verlag 1999

Authors and Affiliations

  • Katsuhiko Horii
    • 1
  • Osamu Yamazaki
    • 1
  • Mitsuharu Matsuyama
    • 1
  • Ikko Higaki
    • 1
  • Shuichi Kawai
    • 1
  • Yoshihiro Sakaue
    • 2
  1. 1.Department of SurgeryOsaka City General HospitalOsakaJapan
  2. 2.Infectious Disease CenterOsaka City General HospitalOsakaJapan

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