Published online Aug 16, 2021. doi: 10.12998/wjcc.v9.i23.6781
Peer-review started: January 16, 2021
First decision: May 5, 2021
Revised: May 11, 2021
Accepted: July 5, 2021
Article in press: July 5, 2021
Published online: August 16, 2021
Processing time: 201 Days and 11.9 Hours
Foreign bodies stuck in the throat and esophagus can be discharged through the digestive tract. Esophageal-lodged foreign bodies can cause secondary injury or detrimental response, with hepatic abscess being one such, albeit rare, outcome. Review and discussion of the few case reports on such instances will help to improve the overall understanding of such conditions and aid in differential diagnosis to improve patient outcome.
A 51-year-old female patient with pre-existing diabetes visited our hospital following a 15-d experience of chills and fever. Both plain and enhanced magnetic resonance imaging and color Doppler ultrasound examination of the liver and gallbladder revealed a space-occupying lesion in the caudate lobe of the liver (7.8 cm × 6.0 cm × 5.0 cm). Initially, a malignant tumor was suspected, but differential diagnosis was unable to exclude the possibility of hepatic abscess. Conservative anti-infection therapy produced a less than ideal outcome. Additional examination by hepatobiliary imaging with computed tomography suggested a foreign body present in the upper abdomen and hepatic abscess, and subsequent endoscopy revealed a sinus tract in the anterior wall of the duodenal bulb. Therefore, surgery was performed to remove the object (fishbone) and drain the abscess. After a 2-wk uneventful recovery, the patient was discharged. The final diagnosis was foreign body-induced hepatic abscess of the caudate lobe.
Differential diagnosis is important for hepatic masses, and systematic examination and physician awareness can aid in diagnosing and curing such rare conditions.
Core Tip: Most foreign bodies that become lodged in the throat and esophagus can be discharged uneventfully through the digestive tract, but rare patients will suffer gastrointestinal perforation. We report here the case of an elderly woman whose hepatic abscess caused by transverse of an esophageal foreign body was misdiagnosed as cystadenocarcinoma. The magnetic resonance imaging diagnosis of malignant tumor was not supported by computed tomography and endoscopy findings. Ultimately, surgery and 2-wk anti-infective drug course resolved this case of foreign body-induced hepatic abscess of the caudate lobe. This case emphasizes the importance of differential diagnosis for hepatic masses.