title: Colonoscopic identification of a foreign body causing an hepatic abscess.
abstract: BACKGROUND
  Hepatic abscesses often result from a perforation of the gastrointestinal tract. Although rare, this may occur via puncture by a foreign body. The object may directly extend from the stomach or duodenum into the liver, or rarely, the object may perforate the bowel distal to the duodenum and indirectly extend to the liver leading to the formation of an abscess.
  
  
  METHODS
  A 44-year-old man developed an hepatic abscess. Although the abscess was identified on computed tomography, various imaging studies were unable to identify the cause of the infection. After an extended ICU course, the patient was deemed stable enough to undergo a colonoscopy that demonstrated a foreign body penetrating through the wall of the sigmoid colon.
  
  
  CONCLUSIONS
  Here we describe the first report of a foreign body leading to a hepatic abscess where the object was identified by colonoscopy. In addition, we present a comprehensive literature review examining the method of identification of gastrointestinal foreign bodies that led to liver abscesses. These findings emphasize that in cases of hepatic abscesses of unknown etiology, direct visualization by colonoscopy may be a useful tool to elucidate the cause of the abscess.
authors.affiliation: Department of Medicine, Indiana University School of Medicine, University Hospital, 2300, Indianapolis, Indiana 46202, USA. drex@iupui.edu
authors.forename: Karl Y
authors.initials: KY
authors.lastname: Bilimoria
authors.forename: Roger K
authors.initials: RK
authors.lastname: Eagan
authors.forename: Douglas K
authors.initials: DK
authors.lastname: Rex
mesh_terms: D000328:Adult; D012809:Colon, Sigmoid; D003113:Colonoscopy; D005547:Foreign Bodies / Q000150:complications / Q000175:diagnosis*; D005548:Foreign-Body Migration / Q000150:complications; D006801:Humans; D007416:Intestinal Perforation / Q000150:complications; D008100:Liver Abscess / Q000000981:diagnostic imaging / Q000209:etiology*; D008297:Male; D014057:Tomography, X-Ray Computed