Hepatic abscess secondary to a rosemary twig migrating from the stomach into the liver

Abstract

The ingestion of a foreign body that penetrates the gastric wall and migrates to the liver, where it causes an abscess is uncommon. A case of an ingested rosemary twig perforating the gastric antrum, then migrating to the liver, complicated by hepatic abscess and Staphylococcus aureus sepsis is reported. A 59-year-old man without a history of foreign body ingestion was admitted to our hospital because of sepsis and epigastralgia, which had progressively worsened. No foreign body was identified at preoperative imaging, but a rosemary twig was discovered during laparotomy. The liver abscess and sepsis were controlled successfully with surgery and antibiotics. This unusual condition should be kept in mind when dealing with cases of hepatic abscess, or even sepsis of unknown origin. Despite the improvement of non-surgical techniques such as percutaneous drainage and interventional endoscopy, surgery still remains important in the treatment of hepatic abscess caused by an ingested foreign body.

Dental root canal treatment complicated by foreign body ingestion: a case report

“…The subsequent foreign body migration can lead to abscess or fistulae formation, which can present a diagnostic challenge in late presentations. [ 10 ]…”

Metallic Foreign Body in the Liver of a Dog

“…We were also able to find some artifacts made by metallic foreign material or contrast media. Although there has been one case of antibiotic therapy only [2], the recommended treatment is exploratory laparotomy to drain the hepatic abscess and eliminate the foreign body if a hepatic abscess secondary to a hepatic foreign body is detected [3,9,10,16]. Despite the benign evolution, the hepatic foreign body in the present case was considered a potentially risk factor for gall bladder rupture or abscess formation because of its location, and it was therefore removed as fast as possible.…”

“…However, an ingested foreign body may cause hemorrhage, perforation or obstruction. Gastrointes-tinal perforation has been reported in less than 1% of patients with long, thin and sharp foreign bodies, such as chicken and fish bones, toothpicks and needles, pens, toothbrushes and dental plates [3,10,16]. Forty-six cases of foreign bodies penetrating the liver have been reported worldwide, and hepatic abscess developed in all of the cases.…”

“…In addition, the dog recovered by changing its diet without specific medical treatment. A migrating foreign body remains asymptomatic for a long time if there are no features of infection or abscess formation [3,10,16].…”

“…In diagnosis of an ingested foreign body, methods of foreign body detection include radiography, ultrasound, CT, MRI, upper gastrointestinal tract endoscopy, colonoscopy and laparotomy [2,10,16]. Radiopaque foreign body may be identified with plain abdominal radiography.…”