Published online Dec 26, 2022. doi: 10.12998/wjcc.v10.i36.13402
Peer-review started: September 7, 2022
First decision: October 12, 2022
Revised: October 28, 2022
Accepted: December 5, 2022
Article in press: December 5, 2022
Published online: December 26, 2022
Pyogenic liver abscess (PLA) due to foreign body penetration of the gastrointestinal tract is rare but can lead to serious consequences if not diagnosed and managed properly. We report a case of PLA caused by a fishbone puncture.
This report describes the clinical features, diagnosis and treatment of a 56-year-old male patient who presented with severe pneumonia, acute respiratory failure and septic shock. The main clinical manifestation was a nonspecific recurrent infection. Based on the findings of abdominal computed tomography examination and the detailed medical history, the diagnosis was made as PLA which was caused by fishbone puncture through the stomach wall and into the liver. After active anti-inflammatory treatment, the patient's general condition had improved. The laparoscopic drainage of the liver abscess and the foreign body removal was performed. There was no recurrence of abscess at discharge or during follow-up and the patient’s general condition was satisfactory.
PLA caused by foreign bodies usually requires surgical treatment or percutaneous drainage combined with antibiotics. Our case confirms that a laparoscopic approach is safe and feasible for such cases.
Core Tip: Pyogenic liver abscess (PLA) secondary to perforation of the gastrointestinal tract by a foreign body usually requires surgical treatment. This case report shows that the diagnosis of PLA caused by a foreign body is a medical challenge. Patients usually present with atypical symptoms. Clinicians should make a timely diagnosis and perform surgical intervention promptly.