title: Ruptured hepatic abscess caused by fish bone penetration of the duodenal wall: report of a case.
abstract: The accidental ingestion of a foreign body into the gastrointestinal tract is not uncommon; however, the development of a hepatic abscess secondary to foreign body perforation is extremely rare. We report the case of a ruptured hepatic abscess caused by fish bone penetration of the duodenal bulb, resulting in generalized peritonitis. A 73-year-old man was admitted to our hospital with generalized abdominal pain and high fever. Computed tomography of the abdomen showed ascites and a heterogeneously enhanced mass with a less-dense center and a linear dense object. We diagnosed a ruptured hepatic abscess caused by a calcified foreign body, which was managed by peritoneal lavage, drainage of the hepatic abscess, and removal of the fish bone, followed by simple closure of the hepatoduodenal fistula. The patient's postoperative course was complicated by systemic inflammatory response syndrome, but he recovered eventually.
authors.affiliation: Department of Surgery, Kobe Red Cross Hospital, 1-3-1 Wakinohamakaigan-dori, Chuo-ku, Kobe 651-0073, Japan.
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Kadowaki
authors.forename: Ryuji
authors.initials: R
authors.lastname: Tamura
authors.forename: Takahiro
authors.initials: T
authors.lastname: Okamoto
authors.forename: Takeki
authors.initials: T
authors.lastname: Mori
authors.forename: Takashi
authors.initials: T
authors.lastname: Mori
mesh_terms: D000368:Aged; D000818:Animals; D001842:Bone and Bones; D003937:Diagnosis, Differential; D004322:Drainage; D004386:Duodenum / Q000293:injuries*; D005399:Fishes; D005500:Follow-Up Studies; D005548:Foreign-Body Migration / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D006801:Humans; D008099:Liver / Q000293:injuries*; D008100:Liver Abscess / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D008297:Male; D012422:Rupture, Spontaneous; D014057:Tomography, X-Ray Computed