Liver abscess caused by fish bone perforation of stomach wall treated by laparoscopic surgery: a case report

Formation of a liver abscess due to gastrointestinal perforation by a foreign body is rare. In addition, there are few case reports on laparoscopic surgical treatment of a liver abscess caused by perforation of the gastrointestinal tract by a foreign body.

A 51-year-old man visited our hospital because of fever and anorexia. There were no physical findings except for fever. He had no comorbidities or surgical history. Laboratory tests showed increased inflammatory marker and liver enzyme levels. Abdominal ultrasonography showed a hypoechoic lesion in the left lobe of the liver. Abdominal contrast-enhanced computed tomography revealed an air-containing abscess in the left side of the liver and a high-density linear object. We diagnosed a liver abscess secondary to stomach perforation by a foreign body. Emergency laparoscopic surgery identified a fish bone in the abscess that formed between the stomach and liver. We succeeded in removing the fish bone laparoscopically. The patient was discharged without any postoperative complications on day 11.

A liver abscess secondary to perforation of the gastrointestinal tract by a foreign body usually requires surgical treatment. Foreign body removal is important to prevent recurrence of liver abscess. In cases with the foreign body located at the liver margin, a laparoscopic approach to the abscess is very useful.