An-Najah Staff

OBJECTIVES: Ingestion and migration of fish bone through the gastrointestinal wall is a rare cause of abscess’s affecting the liver and pancreas. We present cases of pyogenic liver and pancreatic abscess’s caused by fish bone migration through the gastrointestinal wall.
CASE REPORT: The first case is a 34 years old male patient presented with fever for five days associated with cough, epigastric pain and vomiting. Abdominal CT scan showed an abscess at segmet III of the liver with a calcified foreign body pointing from the gastric pylorus to the inferior aspect of the left lobe of the liver. An open drainage was required to remove the foreign body which proved to be a fishbone, the abscess drained and the perforation site at the pylorus was sutured primarily. The second patient was a 65 years old female patient who presented to our hospital with 4 days history of constant epigastric pain radiating to the back. She also had fever, intermittent chills and rigors. CT scan showed an abscess in the head of pancreas with a calcified foreign body that have penetrated the duodenum to the head of pancreas with a localized abscess in the head of pancreas. Open drainage was also required in this patient in which the foreign body which proved to be a fishbone was removed and drain left there for few days. Both patients recovered and discharged well.
CONCLUSION: Although fish bone ingestion is a common problem, most cases have uneventful outcome. But occasionally it can cause serious complications if the gastrointestinal tract is perforated including liver and pancreatic abscesses. If often requires surgical drainage to remove the fish bone.

OBJECTIVES: The purpose of this study was to report the authors' experience with hepatic resection for cystic lesions of the liver, and to identify the outcome.
MATERIALS AND METHODS: A retrospective review of patients who had liver resection for cystic lesions between January 1, 2003, and December 31, 2010 was carried out at Selayang Hospital, a tertiary referral centre in Malaysia. RESULTS: 63 patients (11 male, 52 females) with a median age of 53.5 (range 25–78 years) underwent surgical treatment for nonparasitic cystic liver lesions. There was one mortality (1.6%), and morbidity developed in 8 patients (12.7%). Symptomatic relief was complete and permanent in all of the patients with benign congenital cysts and biliary cystadenomas. None of the patients developed recurrence during the follow up period. In patients with polycystic liver disease, symptomatic relief after surgery was prompt, but temporary.
CONCLUSION: Hepatic resection is safe and effective for cystic lesions of the liver. Symptomatic relief is complete and permanent after hepatic resection, except in cases of diffuse polycystic disease of the liver where liver transplantation should be considered when symptoms are extremely severe. Further studies are required to identify the role of laparoscopic management of symptomatic single or localized multiple cysts.