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Published in: BMC Surgery 1/2003

Open Access 01-12-2003 | Research article

Liver abscess secondary to a broken needle migration- A case report

Authors: Chintamani, Vinay Singhal, Parminder Lubhana, Rakesh Durkhere, Shabnam Bhandari

Published in: BMC Surgery | Issue 1/2003

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Abstract

Background

Perforation of gut by sharp metallic objects is rare and rarer still is their migration to sites like liver. The symptoms may be non-specific and the discovery of foreign body may come as a radiological surprise to the unsuspecting clinician since the history of ingestion is difficult to obtain.

Case report

A unique case of a broken sewing needle in the liver causing a hepatic abscess and detected as a radiological surprise is presented. The patient had received off and on treatment for pyrexia for the past one year at a remote primary health center. Exploratory laparotomy along with drainage of abscess and retrieval of foreign body relieved the patient of his symptoms and nearly one-year follow up reveals a satisfactory recovery.

Conclusion

It is very rare for an ingested foreign body to lodge in the liver and present as a liver abscess. An ultrasound and a high clinical suspicion index is the only way to diagnose these unusual presentations of migrating foreign bodies. The management is retrieval of the foreign body either by open surgery or by percutaneous transhepatic approach but since adequate drainage of the abscess and ruling out of a fistulous communication between the gut and the liver is mandatory, open surgery is preferred.
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Literature
1.
go back to reference Able RM, Fischer JE, Hendren WH: Penetration of the alimentary tract by a foreign body with migration to the liver. Arch Surg. 1971, 102: 227-28.CrossRef Able RM, Fischer JE, Hendren WH: Penetration of the alimentary tract by a foreign body with migration to the liver. Arch Surg. 1971, 102: 227-28.CrossRef
2.
go back to reference Lambert A: Abscess of the liver of unusual origin. NY Med J. 1898, 177-78. Lambert A: Abscess of the liver of unusual origin. NY Med J. 1898, 177-78.
3.
go back to reference Crankson SJ: hepatic foreign body in a child. Pediatr Surg Int. 1997, 12: 426-427. 10.1007/s003830050170.CrossRefPubMed Crankson SJ: hepatic foreign body in a child. Pediatr Surg Int. 1997, 12: 426-427. 10.1007/s003830050170.CrossRefPubMed
4.
go back to reference Lofti M: Foreign body in the liver. Int Surg. 1976, 61: 228- Lofti M: Foreign body in the liver. Int Surg. 1976, 61: 228-
5.
go back to reference Ward A, Ribchester J: Management of ingested foreign bodies in childhood. BMJ. 1978, 4: 469-472. Ward A, Ribchester J: Management of ingested foreign bodies in childhood. BMJ. 1978, 4: 469-472.
6.
7.
go back to reference Maleki M, Evans WE: Foreign body perforation of the intestinal tract. Report of 12 cases and review of literature. Arch Surg. 1970, 102: 227-228. Maleki M, Evans WE: Foreign body perforation of the intestinal tract. Report of 12 cases and review of literature. Arch Surg. 1970, 102: 227-228.
8.
go back to reference Theodoropoulou A, Roussomoustakaki M, Michalodimitrakis MN: Fatalliver abscess caused by a fish bone. Lancet. 2002, 359 (9310): 977-10.1016/S0140-6736(02)07999-0.CrossRefPubMed Theodoropoulou A, Roussomoustakaki M, Michalodimitrakis MN: Fatalliver abscess caused by a fish bone. Lancet. 2002, 359 (9310): 977-10.1016/S0140-6736(02)07999-0.CrossRefPubMed
9.
go back to reference Kumar S, Gupta NM: Foreign bodies migrating from gut to liver. Indian J Gastroenterol. 2000, 19 (1): 42-PubMed Kumar S, Gupta NM: Foreign bodies migrating from gut to liver. Indian J Gastroenterol. 2000, 19 (1): 42-PubMed
10.
go back to reference Tsui BC, Mossey J: Occult liver abscess following clinically unsuspected ingestion of foreign bodies. Can J Gastroenterol. 1997, 11 (5): 445-8.CrossRefPubMed Tsui BC, Mossey J: Occult liver abscess following clinically unsuspected ingestion of foreign bodies. Can J Gastroenterol. 1997, 11 (5): 445-8.CrossRefPubMed
11.
go back to reference Horii K, Yamazaki O, Matsuyama M: Successful Treatment of a Hepatic Abscess that Formed Secondary to Fish Bone Penetration by Percutaneous Transhepatic Removal Of Foreign Body: Report of a Case. Jpn J Surg. 1999, 29: 922-926. 10.1007/s005950050540. Horii K, Yamazaki O, Matsuyama M: Successful Treatment of a Hepatic Abscess that Formed Secondary to Fish Bone Penetration by Percutaneous Transhepatic Removal Of Foreign Body: Report of a Case. Jpn J Surg. 1999, 29: 922-926. 10.1007/s005950050540.
12.
go back to reference de la Vega M, Rivero JC, Ruiz L, Suarez S: A fish bone in the liver. Lancet. 2001, 358: 982-10.1016/S0140-6736(01)06106-2.CrossRefPubMed de la Vega M, Rivero JC, Ruiz L, Suarez S: A fish bone in the liver. Lancet. 2001, 358: 982-10.1016/S0140-6736(01)06106-2.CrossRefPubMed
13.
go back to reference Chen SM, Shen MT, Lo GH: Duodenal perforation with liver abscess caused by ingestion of a chicken bone. Chin J Gastroenterol. 1993, 10: 312-319. Chen SM, Shen MT, Lo GH: Duodenal perforation with liver abscess caused by ingestion of a chicken bone. Chin J Gastroenterol. 1993, 10: 312-319.
14.
go back to reference Bloom RR, Nakano PH, Grey SW: Foreign bodies of the gastrointestinal tract. Am Surg. 1986, 52: 618-21.PubMed Bloom RR, Nakano PH, Grey SW: Foreign bodies of the gastrointestinal tract. Am Surg. 1986, 52: 618-21.PubMed
15.
go back to reference Byard RW, Gilbert JD: Hepatic abscess formation and unexpected death:a delayed complication of occult intraabdominal foreign body. Am J Forensic Med Pathol. 2001, 22 (1): 88-91. 10.1097/00000433-200103000-00018.CrossRefPubMed Byard RW, Gilbert JD: Hepatic abscess formation and unexpected death:a delayed complication of occult intraabdominal foreign body. Am J Forensic Med Pathol. 2001, 22 (1): 88-91. 10.1097/00000433-200103000-00018.CrossRefPubMed
16.
go back to reference Kanazawa S, Ishigaki K, Miyake T: a granulomatous liver abscess which developed after a tooth pick penetrated the intestinal tract: report of a case. Surg Today. 2003, 33 (4): 312-4. 10.1007/s005950300071.CrossRefPubMed Kanazawa S, Ishigaki K, Miyake T: a granulomatous liver abscess which developed after a tooth pick penetrated the intestinal tract: report of a case. Surg Today. 2003, 33 (4): 312-4. 10.1007/s005950300071.CrossRefPubMed
17.
go back to reference Drnosvsek V, Fontanez-Garcia D, Wakabayashi MN, Plavsic BM: Gastrointestinal case of the day. Pyogenic liver abscess caused by perforation caused by a swallowed wooden toothpick. Radiographics. 1999, 19 (3): 820-2.CrossRef Drnosvsek V, Fontanez-Garcia D, Wakabayashi MN, Plavsic BM: Gastrointestinal case of the day. Pyogenic liver abscess caused by perforation caused by a swallowed wooden toothpick. Radiographics. 1999, 19 (3): 820-2.CrossRef
18.
go back to reference Broome CJ, Peck RJ: Hepatic abscess complicating foreign body perforation of the gastric antrum: an ultrasound diagnosis. Clin Radiol. 2000, 55: 242-43. 10.1053/crad.1999.0339.CrossRefPubMed Broome CJ, Peck RJ: Hepatic abscess complicating foreign body perforation of the gastric antrum: an ultrasound diagnosis. Clin Radiol. 2000, 55: 242-43. 10.1053/crad.1999.0339.CrossRefPubMed
19.
go back to reference Masunaga S, Abe M, Imura T: Hepatic abscess secondary to a fish bone penetrating the gastric wall: CT demonstration. Comp Med Imag Graph. 1991, 15: 113-116.CrossRef Masunaga S, Abe M, Imura T: Hepatic abscess secondary to a fish bone penetrating the gastric wall: CT demonstration. Comp Med Imag Graph. 1991, 15: 113-116.CrossRef
20.
go back to reference Strauss JE, Balthazar FJ, Naidieh DP: Jejunal perforation by a tooth pick: CT demonstration. J Comput Assist Tomogr. 1985, 9: 812-814.CrossRefPubMed Strauss JE, Balthazar FJ, Naidieh DP: Jejunal perforation by a tooth pick: CT demonstration. J Comput Assist Tomogr. 1985, 9: 812-814.CrossRefPubMed
Metadata
Title
Liver abscess secondary to a broken needle migration- A case report
Authors
Chintamani
Vinay Singhal
Parminder Lubhana
Rakesh Durkhere
Shabnam Bhandari
Publication date
01-12-2003
Publisher
BioMed Central
Published in
BMC Surgery / Issue 1/2003
Electronic ISSN: 1471-2482
DOI
https://doi.org/10.1186/1471-2482-3-8

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