Fish Bone Induced Liver And Pancreatic Abscess

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Journal Title, Volume, Page: 
Medical Journal of Malaysia;Dec2011 Supplement, Vol. 66, p17
Year of Publication: 
2011
Authors: 
D Khaled
Hospital Selayang, Selangor, Malaysia
Current Affiliation: 
Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
R Krishnan,
Hospital Selayang, Selangor, Malaysia
K F Lim
Hospital Selayang, Selangor, Malaysia
V Thamaria
Hospital Selayang, Selangor, Malaysia
M Suryati
Hospital Selayang, Selangor, Malaysia
W Azrin
Hospital Selayang, Selangor, Malaysia
S Harjit
Hospital Selayang, Selangor, Malaysia
Preferred Abstract (Original): 

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.

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