An unusual zoonosis: liver abscess secondary to asymptomatic colonic foreign body.
A liver abscess may arise following any insult to gut integrity allowing portal drainage of bacteria to hepatocytes. Foreign bodies such as bones, toothpicks and items of stationery have previously been implicated in compromising gut epithelium. Here we present the case of a 57 year old man suffering from a left liver abscess. This was defined on CT which incidentally also identified a chicken bone protruding through the wall of the distal sigmoid colon. Whilst unwell with upper abdominal pain and sepsis, the presumed source of portal sepsis within the colon remained asymptomatic throughout. Following percutaneous drainage, the liver abscess resolved but the chicken bone had not passed at two months, necessitating atraumatic removal at colonoscopy. A high rate of incidental diagnoses suggests that unidentified foreign bodies may be vastly under recognised in cases of hepatic sepsis. Thus, identification of the precise mechanism of the liver insult demands thorough consideration; foreign body should be considered in all cases.
Department of Surgery, Wagga Wagga Base Hospital, University of New South Wales, NSW, Australia. jgundara@gmp.usyd.edu.au
Justin S
JS
Gundara
Richard
R
Harrison
D000818:Animals; D001842:Bone and Bones; D002645:Chickens; D003113:Colonoscopy; D003937:Diagnosis, Differential; D005547:Foreign Bodies / Q000150:complications* / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D008100:Liver Abscess / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed