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

鱼刺刺穿十二指肠壁引起的肝脓肿导致感染性休克和多器官功能衰竭

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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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