Abstract

Introduction: Liver abscess is an infectious space occupying lesion in liver parenchyma. It could be pyogenic or amoebic in origin. The most common source is biliary followed by abdominal infection and hematogenous spread. We describe a patient with liver abscess caused by a fish bone which penetrated into liver capsule through the gastric wall. Methods: A 65 year old male presented with history of fever and mild abdominal discomfort. He was evaluated and was found to have a liver lesion on ultrasonography. Triphasic CECT scan abdomen revealed a liver abscess in segment 4 with hyper dense linear material within. Ultrasound had missed out foreign body within the abscess. On probing, there was history of fish bone ingestion a month earlier. Endoscopy did not reveal any gastric lesion or breach in mucosa. He was given antibiotics and taken up for surgery. Laparoscopic liver abscess drainage was done and foreign body- fish bone was noted within the abscess. Patient improved clinically and was doing well on follow up. Conclusion: Liver abscess due to fish bone penetrating liver capsule through stomach is very rare. The transgastric penetration of foreign body should be kept in mind whenever there is unusual cause of liver abscess with foreign body within. CECT abdomen may be more helpful than an ultrasound abdomen.

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