OUP accepted manuscript

From Harmless to Harmful: A Case Series of Hepatic Abscess Induced by Gut Microbiota Due to Fish Bone

Accidental ingestion of fish bones can lead to serious complications, such as gastrointestinal perforation and hepatic abscesses. This case series presents three instances where fish bone ingestion led to secondary GI tract perforation and the development of hepatic abscesses. It also emphasizes the importance of prompt diagnosis and intervention to prevent serious consequences.

A case report of extremely rare case of fishbone penetration from stomach into spleen, causing splenic abscess, managed by spleen preserving surgery

INTRODUCTION

Fishbone penetrating from the stomach into the spleen, causing a splenic abscess, is an extremely rare condition.

CASE PRESENTATION

We report a case of fishbone penetration from the stomach into the spleen, presenting as a splenic abscess and acute peritonitis, diagnosed pre-operatively with a contrast-enhanced CT scan of the abdomen and subsequently managed with spleen-preserving surgery.

DISCUSSION

Fishbone penetration from the stomach into the spleen, causing a splenic abscess, which is an extremely rare occurrence. We successfully diagnosed and managed this case with spleen-preserving surgery, and the patient recovered well.

CONCLUSION

A rare case of fishbone penetration from the stomach into the spleen causing a splenic abscess was diagnosed radiologically pre-operatively and managed by a spleen-preserving procedure.

A sewing needle in the liver: a case report and literature review

Intrahepatic foreign bodies are rarely reported. Although rare, a few reports of swallowed foreign bodies straying into the liver from the gastrointestinal tract have been published. Herein, we report a case in which an asymptomatic intrahepatic needle was removed laparoscopically. An 81-year-old woman presented to our hospital with an abnormal shadow on her abdominal X-ray image. Abdominal computed tomography displayed a needle-like shadow obliquely lying in the lateral segment of the left lobe of the liver. No subjective symptoms were reported; however, the patient underwent laparoscopic extraction. The postoperative course was good, and the patient was discharged without any complications. We also present a literature review of 27 patients with intrahepatic foreign bodies, a sewing needle.

Surgically treated purulent pericarditis induced by ingested fish bone: a case report

BACKGROUND

Aspiration of fish bones is common, but perforation of the gastrointestinal tract is very rare. Once perforation occurs, fatal complications such as mediastinitis and cardiac tamponade can occur. Here, we present a case of acute pericarditis due to perforation of a fish bone.

CASE PRESENTATION

A 66-year-old woman was referred to our hospital with shortness of breath. Blood tests showed high C-reactive protein, and contrast-enhanced computed tomography showed a large amount of pericardial fluid as well as a foreign body with high bone density in the pericardial sac. Upper gastrointestinal endoscopy showed no evidence of penetration of the esophageal or gastric mucosa. Emergency open chest surgery was performed, and the pericardial sac was filled with copious amounts of pus. The fish bone-like foreign body was found to penetrate the pericardial membrane from the diaphragmatic side. The foreign body was removed, a drainage tube was placed, and the chest was closed. After 2 weeks of postoperative antibiotics, the patient was discharged from the hospital in stable general condition. Three months after the surgery, the patient had no recurrence of pericarditis.

CONCLUSIONS

We reported a rare case of gastrointestinal perforation by a fish bone, resulting in pericardium, which was treated by surgical drainage.

Pyogenic liver abscess secondary to gastric perforation of an ingested toothpick: A case report

BACKGROUND

Liver abscess due to foreign body-induced gastrointestinal tract perforation is a rare event that could be misdiagnosed due to low suspicion. Less than 100 cases have been reported to date.

CASE SUMMARY

We report a case of a 53-year old female patient with pyogenic liver abscess secondary to ingestion of a toothpick with penetration through the lesser curvature of the stomach. The patient presented with persistent epigastric pain. Abdominal computed tomography demonstrated the presence of a linear radiopaque object associated with abscess formation in the left liver lobe. Inflammatory changes in the lesser curvature of the stomach indicated gastric wall penetration by the object. As the abscess was refractory to antibiotic treatment, laparoscopic liver resection was performed to remove the foreign body and adjacent liver parenchyma. Following surgery, symptoms fully resolved without any sequelae.

CONCLUSION

This rare case demonstrates the importance of considering foreign body penetration as a cause of pyogenic liver abscess, particularly in abscesses of unknown origin that are resistant to antibiotic therapy. Clinical suspicion, early diagnosis, and prompt removal of the foreign body could lead to improved outcomes in these patients.

A toothpick inside the liver with no defined access: A rare cause of liver abscess

INTRODUCTION

Foreign body ingestion is not an uncommon occurrence, whereas the complications that may be generated by it are infrequent. The clinical manifestation range from nonspecific symptoms to life threatening conditions. Therefore, these cases continue to be challenging in diagnosis and treatment, especially items that are not radio-opaque.

CASE PRESENTATION

This article demonstrates a rare case of liver abscess induced by a toothpick with an unknown access. A 64-year-old woman was admitted to the Intensive Care Unit when she had developed a septic shock due to liver abscess and a conservative treatment was provided. After that, the patient underwent surgery to extract the foreign body.

DISCUSSION

Tracking the ingested foreign body is not always effortless. Computed Tomography scan plays a significant role in discovering foreign bodies located inside the liver. Surgical intervention is mostly required to remove the foreign body.

CONCLUSION

Foreign body presence inside the liver is a rare incident. The symptoms vary from case to another and whether it is silent or not, it is preferable to remove the foreign body.

Unusual Pancreatic Abscess Secondary to Embedded Fish Bone: A Challenging Clinical Scenario

The incidental ingestion of fish bone is common, and the ingested fish bone mostly exits the gastrointestinal tract spontaneously. However, severe complications such as perforation in the digestive tract and abscess formation after a period of time may occasionally occur. Fewer than 10 cases of a migrated fish bone penetrating into the pancreas have been reported in the literature, and the development of a subsequent pancreatic abscess is extremely rare. We present one such rare case of pancreatic abscess formation in a middle-aged woman due to fish bone penetration through the gastric wall into the pancreas 2 months after ingestion and missed on endoscopy initially. Further imaging revealed that the fish bone was partially embedded in the pancreatic head surrounded with abscesses and was smoothly removed through laparoscopy.