Pancreatic and Hepatic Abscess Secondary to Fish Bone Perforation of the Duodenum

Goh, Brian K. P.; Yong, Wei‐Sean; Yeo, Allen

doi:10.1007/s10620-005-2712-8

Cited by 37 publications

(32 citation statements)

References 15 publications

(18 reference statements)

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“…A review of the English literature revealed only two such cases. 6,7 In the former case, a fi sh bone penetrated the duodenum, similar to our case, and in the latter case, a fi sh bone penetrated the stomach. In these two cases, a pancreatic abscess developed.…”

Section: Discussionsupporting

confidence: 84%

Fish bone penetration of the duodenum extending into the pancreas: Report of a case

et al. 2010

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We report a case of fish bone penetration of the duodenum extending into the pancreatic head, which was successfully treated by surgery. A 73-year-old woman was admitted with upper abdominal dull pain that had persisted for 3 days. Computed tomography showed a linear calcified body, which appeared to penetrate the posterior wall of the duodenal bulb into the pancreatic head. A laparotomy was performed based on the preoperative diagnosis of localized peritonitis caused by penetration of the duodenum into the pancreas by an ingested foreign body. The foreign body was safely removed from both the pancreas and duodenum and was found to be a fish bone, measuring 4 cm in length. Neither an abscess nor hematoma was detected at the site of the pancreatic head. The postoperative course was uneventful. This case demonstrates an unusual presentation of fish bone penetration of the duodenum with a migration to the pancreas.

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Section: Discussionsupporting

confidence: 84%

Fish bone penetration of the duodenum extending into the pancreas: Report of a case

et al. 2010

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“…8 A review of the English literature revealed only nine cases of fi sh bone penetration of the gastrointestinal tract resulting in hepatic abscess. [9][10][11][12][13][14][15][16][17] If the hepatic abscess does not rupture, the symptoms are often subtle and may include fever, chills, and upper abdominal tenderness, with jaundice in 20%-30% of patients. 18 To the best of our knowledge, the development of generalized peritonitis secondary to rupture of a hepatic abscess caused by fi sh bone penetration of the duodenal wall has not been documented earlier.…”

Section: Discussionmentioning

confidence: 99%

Ruptured Hepatic Abscess Caused by Fish Bone Penetration of the Duodenal Wall: Report of a Case

et al. 2007

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The accidental ingestion of a foreign body into the gastrointestinal tract is not uncommon; however, the development of a hepatic abscess secondary to foreign body perforation is extremely rare. We report the case of a ruptured hepatic abscess caused by fish bone penetration of the duodenal bulb, resulting in generalized peritonitis. A 73-year-old man was admitted to our hospital with generalized abdominal pain and high fever. Computed tomography of the abdomen showed ascites and a heterogeneously enhanced mass with a less-dense center and a linear dense object. We diagnosed a ruptured hepatic abscess caused by a calcified foreign body, which was managed by peritoneal lavage, drainage of the hepatic abscess, and removal of the fish bone, followed by simple closure of the hepatoduodenal fistula. The patient's postoperative course was complicated by systemic inflammatory response syndrome, but he recovered eventually.

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“…In some cases, these sharp foreign bodies can perforate the walls of stomach or duodenum and reach the liver. Foreign bodies reaching pancreas and liver parenchyma can cause abscess, pseudoaneurysm, pancreatitis, and high-mortality-risk complications (1,4,5).…”

Section: Discussionmentioning

confidence: 99%

“…Foreign bodies in pancreas might cause serious complications such as pancreatitis, pancreatic abscess, and pseudoaneurysm. These should be removed either endoscopically or surgically (1,3,4). In few cases, foreign bodies can also be removed using open surgical techniques (2,5).…”

Section: Introductionmentioning

confidence: 99%

Foreign body: A sewing needle migrating from the gastrointestinal tract to pancreas

et al. 2018

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Of all ingested foreign bodies, 2.4% comprise of sewing needles. Through perforation of gastrointestinal tract, which occurs in 1% of cases, they can migrate into the liver and pancreas. Foreign bodies in pancreas should be considered in the differential diagnosis of chronic abdominal pain. Computed tomography scans provide valuable information for the localization of the lesion, which guide the surgeon during the operation. Secondary to foreign bodies that migrate to the pancreas, complications with high mortality such as pancreatitis, pseudoaneurysm, and pancreas abscess can be seen. Thus, for this patient group, diagnostic laparoscopy is recommended, considering its advantages of decreased postoperative pain, decreased wound infection, and faster recovery time. Here we present a case of a 23-year-old female patient, from whom an ingested needle that migrated from the back wall of the stomach to the pancreas was extracted by laparoscopic surgery. Keywords: Sewing needle, pancreas, laparoscopy INTRODUCTIONOut of all the ingested foreign bodies, 43.7% are organic, 56.3% are inorganic, and 2.4% are sewing needles. Most of the ingested foreign bodies are excreted spontaneously (1). These foreign bodies may reach pancreas and liver in 1% of patients, through penetration of small intestine or stomach wall (1, 2). Foreign bodies in pancreas might cause serious complications such as pancreatitis, pancreatic abscess, and pseudoaneurysm. These should be removed either endoscopically or surgically (1, 3, 4). In few cases, foreign bodies can also be removed using open surgical techniques (2, 5). However, the suggested technique is the laparoscopic approach before open surgery (3, 6, 7). Here we report the case of a 23-year-old female patient, who presented with epigastric pain and a sewing needle was removed laparoscopically from her pancreas parenchyma. CASE PRESENTATIONA 23-year-old female patient presented with epigastric pain and retrosternal burns that continued intermittently for seven years. She had used proton pump inhibitors (PPI) and as her symptoms did not resolve, she presented to the hospital. In her physical examination, there was minimal tenderness and discomfort in the epigastric area without rebound sign or defense. Laboratory blood tests including her hemogram, biochemical markers, liver function tests, kidney function tests, and amylase levels were within normal limits. Her standing abdominal x-ray was also normal ( Figure 1a). During gastroscopy, no sign of any pathology related to a foreign body was observed. We performed a barium follow-through x-ray with an initial diagnosis of gastroesophageal reflux disease, and in this test, we observed a foreign body in the epigastric area (Figure 1b). When patient's medical history was questioned again, it was found that she had accidentally swallowed a sewing needle seven years ago. She underwent computed tomography screening and we saw that a foreign body was present starting from the posterior side of the stomach reaching head and body of the pancreas. (Fig...

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Pancreatic and Hepatic Abscess Secondary to Fish Bone Perforation of the Duodenum

Cited by 37 publications

References 15 publications

Fish bone penetration of the duodenum extending into the pancreas: Report of a case

Fish bone penetration of the duodenum extending into the pancreas: Report of a case

Ruptured Hepatic Abscess Caused by Fish Bone Penetration of the Duodenal Wall: Report of a Case

Foreign body: A sewing needle migrating from the gastrointestinal tract to pancreas

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