Successful Management of Hepatic Abscess From Ingested Foreign Body: A Case Report

Hepatic abscess secondary to foreign body ingestion is a rare but potentially life-threatening condition. Although most ingested foreign bodies pass harmlessly through the gastrointestinal tract, sharp objects may perforate the gastric or intestinal walls, migrate into adjacent organs, and lead to abscess formation. This report describes a 22-year-old female with a 10-year history of systemic lupus erythematosus (SLE) who presented with persistent epigastric discomfort, nausea, and vomiting for 2 weeks. Initial evaluations, including laboratory tests and abdominal ultrasonography, were unremarkable. Subsequent endoscopy revealed a foreign body lodged in the distal stomach that could not be removed endoscopically. A contrast-enhanced computed tomography (CT) scan demonstrated a 7 cm × 5.6 cm abscess in the left hepatic lobe. The patient underwent laparotomy, which confirmed a toothpick penetrating the gastric wall and lodging in the liver. The abscess was drained, and gastrorrhaphy was performed. The patient recovered uneventfully following antibiotic therapy and was discharged in stable condition, with no recurrence during follow-up. Foreign body-induced hepatic abscesses are uncommon, and diagnosis can be challenging because classical signs of infection may be absent or attenuated. Endoscopy remains the first-line diagnostic and therapeutic approach; however, surgical intervention is required when the foreign body is embedded or complications occur. Clinicians should maintain a high index of suspicion in patients with persistent or unexplained abdominal symptoms, particularly in immunocompromised individuals.