Septic Shock and Multiorgan Failure Related to Liver Abscess Caused by Fish Bone Penetration of Duodenal Wall

TL;DR

An 80-year-old man developed severe liver abscess and septic shock due to a fish bone penetrating the duodenum, requiring surgical removal and recovery.

Contribution

This case highlights an unusual cause of liver abscess and septic shock due to fish bone penetration.

Findings

A fish bone was found lodged between the gastric antrum and a liver abscess cavity.

Surgical removal of the fish bone and drainage of the abscess led to recovery.

The patient responded well to IV antibiotics and surgical intervention.

Abstract

We report an intriguing case of an 80-year-old male presented with high-grade fever and severe upper abdominal pain. An abdominal ultrasound indicated a deep-seated abscess in the Segment IV of liver. An elusive diagnosis was made after Contrast Enhanced Computed Tomography (CECT) scan of whole abdomen which disclosed a sharp, pointed fish bone accommodating between the distal part of gastric antrum and cavitary lesion of liver. In the operative room, an upper GI endoscopy revealed a healed duodenal ulcer. An explorative laparotomy was performed subsequently, and the perihepatic abscess cavity was drained along with the removal of fish bone about 3.15 cm in length from perihilar region without any damage to the adjoining structures. His management was centered around IV antibiotics, imaging, and subsequent surgical drainage. The gentleman made a good recovery.

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