Keywords
Intrahepatic migration
Pyogenic liver abscess
Computed tomography
How to Cite
Abstract
Background: Foreign body ingestion is common; however, migration of an ingested fish bone into the liver with subsequent abscess formation is rare, frequently presents with nonspecific abdominal symptoms, and poses a diagnostic challenge in routine clinical practice, often leading to delayed diagnosis.
Methods: A scoping review of PubMed, Google Scholar, SciELO, and ScienceDirect identified human case reports and case series (2015–2025) describing confirmed intrahepatic fish-bone migration or penetration causing hepatic abscess. Reports without radiologic or intraoperative confirmation and those involving non–fish-bone foreign bodies were excluded. Extracted data included demographics, migration routes, imaging findings, management, and outcomes.
Results: Twenty-seven publications reporting 29 patients met the inclusion criteria, including 25 individual case reports and 2 case series. Presumed transgastric migration was reported in 22 patients (75.9%), and the left hepatic lobe was involved in 20 cases (69.0%). Computed tomography identified a linear radiodense foreign body in 24 patients (82.8%). Surgical or minimally invasive foreign-body removal was performed in 21 patients (72.4%), with generally favorable outcomes, although follow-up reporting was variable.
Conclusion: Intrahepatic fish-bone migration is a rare but clinically important cause of hepatic abscess and should be considered in patients with unexplained, particularly left-lobe, hepatic abscesses when CT demonstrates a linear foreign body or when response to standard therapy is atypical; timely source control is usually effective.
References
1. Santos SA, Alberto SC, Cruz E, Pires E, Figueira T, Coimbra E, Estevez J, Oliveira M, Novais L, Deus JR. Hepatic abscess induced by foreign body: case report and literature review. World J Gastroenterol. 2007: 1466 [PMID: 17457985, https://doi.org/10.3748/wjg.v13.i9.1466]
2. Lambert A. Abscess of the liver of unusual origin. NY Med j. 1898:
3. Masunaga S, Abe M, Imura T, Asano M, Minami S, Fujisawa I. Hepatic abscess secondary to a fishbone penetrating the gastric wall: CT demonstration. Comput Med Imaging Graph. 1991: 113 [PMID: 2059945, https://doi.org/10.1016/0895-6111(91)90034-s]
4. Chan SC, Chen HY, Ng SH, Lee CM, Tsai CH. Hepatic abscess due to gastric perforation by ingested fish bone demonstrated by computed tomography. J Formos Med Assoc. 1999: 145 [PMID: 10083773,
5. Chen J, Wang C, Zhuo J, Wen X, Ling Q, Liu Z, Guo H, Xu X, Zheng S. Laparoscopic management of enterohepatic migrated fish bone mimicking liver neoplasm: A case report and literature review. Medicine (Baltimore). 2019: e14705 [PMID: 30882633, https://doi.org/10.1097/MD.0000000000014705]
6. Panebianco A, Lozito RC, Prestera A, Ialongo P, Volpi A, Carbotta G, Palasciano N. Unusual liver abscess secondary to ingested foreign body: laparoscopic management. G Chir. 2015: 74 [PMID: 26017106, https://doi.org/10.11138/gchir/2015.36.2.074]
7. Morelli L, Morelli JN, Rosati CM, Guadagni S, Doria R, Pisano R, Crocetti L, Tagliaferri E, Mosca F. Hepatic abscess caused by trans-gastric migration of a fishbone. Surg Infect (Larchmt). 2015: 206 [PMID: 24815531, https://doi.org/10.1089/sur.2013.254]
8. Venkatesh SH, Sanamandra SK. Large hepatic abscess caused by fish bone. Saudi Med J. 2015: 878 [PMID: 26108597, https://doi.org/10.15537/smj.2015.7.11779]
9. Ede C, Sobnach S, Kahn D, Bhyat A. Enterohepatic Migration of Fish Bone Resulting in Liver Abscess. Case Rep Surg. 2015: 238342 [PMID: 26634168, https://doi.org/10.1155/2015/238342]
10. Peixoto A, Goncalves R, Macedo G. Liver Abscess Associated Sepsis Caused by Fish Bone Ingestion. GE Port J Gastroenterol. 2016: 322 [PMID: 28868489, https://doi.org/10.1016/j.jpge.2016.03.006]
11. Tan CH, Chang SY, Cheah YL. Laparoscopic Removal of Intrahepatic Foreign Body: A Novel Technique for Management of an Unusual Cause of Liver Abscess--Fish Bone Migration. J Laparoendosc Adv Surg Tech A. 2016: 47 [PMID: 26779724, https://doi.org/10.1089/lap.2015.0487]
12. PEIXE D. ABSCESSO HEPÁTICO SECUNDÁRIO À PERFURAÇÃO GÁSTRICA POR ESPINHA:
13. Bandeira-de-Mello RG, Bondar G, Schneider E, Wiener-Stensmann IC, Gressler JB, Kruel CRP. Pyogenic Liver Abscess Secondary to Foreign Body (Fish Bone) Treated by Laparoscopy: A Case Report. Ann Hepatol. 2018: 169 [PMID: 29311403, https://doi.org/10.5604/01.3001.0010.7550]
14. Mateus JE, Silva C, Beirao S, Pimentel J. Hepatic Abscess Induced by Fish Bone Migration: Two Case Reports. Acta Med Port. 2018: 276 [PMID: 29916359, https://doi.org/10.20344/amp.9662]
15. Yu W, Yu H, Ling J, Du J, Yin Z, Li C, Zhou M. Hepatic Abscess Secondary to Stomach Perforation by a Fish Bone: a Rare Cause of Hepatic Abscess. Ann Hepatol. 2018: 880 [PMID: 30145566, https://doi.org/10.5604/01.3001.0012.3171]
16. Bekki T, Fujikuni N, Tanabe K, Amano H, Noriyuki T, Nakahara M. Liver abscess caused by fish bone perforation of stomach wall treated by laparoscopic surgery: a case report. Surg Case Rep. 2019: 79 [PMID: 31093821, https://doi.org/10.1186/s40792-019-0639-0]
17. Li J, Zhao D, Lei L, Zhang L, Yu Y, Chen Q. Liver abscess caused by ingestion of fishbone: A case report. Medicine (Baltimore). 2019: e16835 [PMID: 31441855, https://doi.org/10.1097/MD.0000000000016835]
18. Burkholder R, Samant H. Management of Fish Bone-Induced Liver Abscess with Foreign Body Left In Situ. Case Reports Hepatol. 2019: 9075198 [PMID: 31285930, https://doi.org/10.1155/2019/9075198]
19. Sim GG, Sheth SK. Retained Foreign Body Causing a Liver Abscess. Case Rep Emerg Med. 2019: 4259646 [PMID: 31934467, https://doi.org/10.1155/2019/4259646]
20. Hernandez-Villafranca S, Qian-Zhang S, Garcia-Olmo D, Villarejo-Campos P. Liver abscess due to a fish bone injury: A case report and review of the literature. Cir Cir. 2020: 1 [PMID: 33284283, https://doi.org/10.24875/CIRU.20000030]
21. Barkai O, Kluger Y, Ben-Ishay O. Laparoscopic retrieval of a fishbone migrating from the stomach causing a liver abscess: Report of case and literature review. J Minim Access Surg. 2020: 418 [PMID: 31793447, https://doi.org/10.4103/jmas.JMAS_196_19]
22. Enes Silva J, Pinelas S, Pacheco M, Patacho M, Almeida J. Gastric perforation by fish bone with hepatic abscess formation presenting as prolonged fever. IDCases. 2021: e01159 [PMID: 34026546, https://doi.org/10.1016/j.idcr.2021.e01159]
23. Grayson N, Shanti H, Patel AG. Liver abscess secondary to fishbone ingestion: case report and review of the literature. J Surg Case Rep. 2022: rjac026 [PMID: 35178243, https://doi.org/10.1093/jscr/rjac026]
24. Xia F, Zhu P, Chen XP, Zhang BX, Zhang MY. Liver abscess in the caudate lobe caused by a fishbone and treated by laparoscopy: a case report. BMC Surg. 2022: 6 [PMID: 34996410, https://doi.org/10.1186/s12893-021-01457-z]
25. Dai MG, Zheng JJ, Yang J, Ye B. Intragastric fish bones migrate into the liver: A case report. World J Clin Cases. 2023: 3256 [PMID: 37274031, https://doi.org/10.12998/wjcc.v11.i14.3256]
26. Okhotnikov OI, Yakovleva MV, Krasnikov PA, Okhotnikov OO. [Recurrent bacterial abscess of the left liver lobe caused by a foreign body (fish bone)]. Khirurgiia (Mosk). 2024: 91 [PMID: 38258694, https://doi.org/10.17116/hirurgia202401191]
27. Cuesta Pertuz AA, Mosquera López OA, Palacios Cuesta IC, Mosquera López JA, De León Valdés DP. Absceso hepático por espina de pescado: reporte de caso. Revista colombiana de Gastroenterología. 2024: 332 https://doi.org/10.22516/25007440.1117]
28. Khan A, Bhardhan V, Sahoo AK. Fish Bone Induced Hepatic Abscess : A Rare Case. JK Science: Journal of Medical Education & Research. 2025: 66
29. Ahmed S, Ferdous N, Mamoon MAA, Azam MG, Datta IK, Bhuiyan TM, Rowshon AHM. Fish bone induced liver abscess: a rare case report. BIRDEM Medical Journal. 2025: 51 https://doi.org/10.3329/birdem.v15i1.79321]
30. Zong Y, Zhang Y, Zhang H. Fishbone penetration leading to pyogenic liver abscess: A case report. Trop Doct. 2025: 163 [PMID: 39512231, https://doi.org/10.1177/00494755241297208]
31. Abdennebi S, Babana El Alaoui A, Ifrine L, Belkouchi A, Belkouchi O. Liver Abscess Due to an Unusual Foreign Body: A Case Report. Cureus. 2025: e87420 [PMID: 40772203, https://doi.org/10.7759/cureus.87420]
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