Kadi A, Tuergan T, Abulaiti Y, Shalayiadang P, Tayier B, Abulizi A, Tuohuti M, Ahan A. Laparoscopic treatment of pyogenic liver abscess caused by fishbone puncture through the stomach wall and into the liver: A case report. World J Clin Cases 2022; 10(36): 13402-13407 [PMID: 36683634 DOI: 10.12998/wjcc.v10.i36.13402]
Corresponding Author of This Article
Ayifuhan Ahan, MAMS, Doctor, Department of Hepatobiliary and Hydatid Disease, Digestive and Vascular Center, First Affiliated Hospital of Xinjiang Medical University, No. 137 South Liyushan Road, Xinshi District, Urumqi 830054, Xinjiang Uygur Autonomous Region, China. akejan@126.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Abudureyimu Kadi, Talaiti Tuergan, Yierpan Abulaiti, Paizula Shalayiadang, Baihetiyaer Tayier, Abududuaini Abulizi, Ayifuhan Ahan, Department of Hepatobiliary and Hydatid Disease, Digestive and Vascular Center, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, Xinjiang Uygur Autonomous Region, China
Muniremu Tuohuti, Department of General Medicine, First People's Hospital of Aksu Region, Aksu 843099, Xinjiang Uygur Autonomous Region, China
Author contributions: Kadi A and Tuergan T are the co-first authors who organized the case content, collected all relevant data and drafted the manuscript; Shalayiadang P performed the surgical procedure; Tayier B and Tuohuti M participated in collecting the clinical data; Abulaiti Y and Abulizi A performed the literature research and contributed to manuscript revision; Ahan A conceived the study design, interpreted all data and revised the manuscript in depth; all authors have read and approved the final manuscript.
Supported bythe Open Project of the State Key Laboratory of Pathogenesis, No. SKL-HIDCA-2019; and Prevention and Treatment of High Incidence Diseases in Central Asia jointly established by the Provincial Government and the Ministry, No. SKL-HIDCA-2022-34.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors report having no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ayifuhan Ahan, MAMS, Doctor, Department of Hepatobiliary and Hydatid Disease, Digestive and Vascular Center, First Affiliated Hospital of Xinjiang Medical University, No. 137 South Liyushan Road, Xinshi District, Urumqi 830054, Xinjiang Uygur Autonomous Region, China. akejan@126.com
Received: September 7, 2022 Peer-review started: September 7, 2022 First decision: October 12, 2022 Revised: October 28, 2022 Accepted: December 5, 2022 Article in press: December 5, 2022 Published online: December 26, 2022 Processing time: 110 Days and 15.1 Hours
Abstract
BACKGROUND
Pyogenic liver abscess (PLA) due to foreign body penetration of the gastrointestinal tract is rare but can lead to serious consequences if not diagnosed and managed properly. We report a case of PLA caused by a fishbone puncture.
CASE SUMMARY
This report describes the clinical features, diagnosis and treatment of a 56-year-old male patient who presented with severe pneumonia, acute respiratory failure and septic shock. The main clinical manifestation was a nonspecific recurrent infection. Based on the findings of abdominal computed tomography examination and the detailed medical history, the diagnosis was made as PLA which was caused by fishbone puncture through the stomach wall and into the liver. After active anti-inflammatory treatment, the patient's general condition had improved. The laparoscopic drainage of the liver abscess and the foreign body removal was performed. There was no recurrence of abscess at discharge or during follow-up and the patient’s general condition was satisfactory.
CONCLUSION
PLA caused by foreign bodies usually requires surgical treatment or percutaneous drainage combined with antibiotics. Our case confirms that a laparoscopic approach is safe and feasible for such cases.
Core Tip: Pyogenic liver abscess (PLA) secondary to perforation of the gastrointestinal tract by a foreign body usually requires surgical treatment. This case report shows that the diagnosis of PLA caused by a foreign body is a medical challenge. Patients usually present with atypical symptoms. Clinicians should make a timely diagnosis and perform surgical intervention promptly.
