Multimodal treatment for liver abscess caused by fish bone migration: a case report

A 77-year-old man with diabetes developed a fever the day after eating black porgy and was admitted to a nearby hospital. Computed tomography revealed an ~3-cm fish bone that had migrated from the duodenum into the liver, with a surrounding liver abscess. His symptoms did not improve with antibiotic treatment, and he was referred to our hospital on Day 3. Gastroduodenoscopy did not identify the fish bone within the duodenal lumen. Although the antibiotic regimen was changed, his fever persisted and his condition worsened. On hospital Day 7, percutaneous transhepatic abscess drainage was performed, after which the inflammatory response and his condition gradually improved. Laparoscopic removal of the fish bone was performed on hospital day 15. The fish bone was identified within the liver, adjacent to the duodenal bulb, and was removed smoothly. The patient's postoperative course was uneventful.