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胃壁鱼刺穿孔致肝脓肿合并血流感染的微创介入治疗:一例报告

Minimally Invasive Interventional Therapy for Liver Abscess with Bloodstream Infection Caused by a Fishbone Perforation of the Stomach Wall: A Case Report.

作者信息

Zhang Aiping, Wei Wei, Pei Renguang, Li Xiaoning, Yang Jinsun

机构信息

Department of Infectious Diseases, Yijishan Hospital of Wannan Medical College, Wuhu, Anhui, 241001, People's Republic of China.

Department of Sonography, Yijishan Hospital of Wannan Medical College, Wuhu, Anhui, 241001, People's Republic of China.

出版信息

Infect Drug Resist. 2025 Apr 25;18:2087-2092. doi: 10.2147/IDR.S515201. eCollection 2025.

DOI:10.2147/IDR.S515201
PMID:40290402
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12034346/
Abstract

Liver abscess is a common disease in clinical practice, whereas liver abscess resulting from the penetration of a fishbone through the gastric wall is infrequently observed. Herein, we present the case of a 67-year-old male patient of Chinese origin. The patient had been experiencing a fever for 10 days and was subsequently admitted to the hospital. Laboratory investigations revealed elevated levels of inflammatory markers, with blood cultures identifying s (). Imaging studies including abdominal ultrasound and contrast-enhanced computerized tomography (CT) confirmed the presence of an abscess in the left hepatic lobe, along with foreign bodies located within both the liver parenchyma and the gastric wall. Based on the patient's medical history and imaging results, the ultimate diagnosis indicated that a fishbone had perforated the stomach wall, resulting in an intrahepatic abscess and subsequent bacteremia. The patient underwent anti-infection therapy followed by a minimally invasive interventional technique to remove the fishbone. This case shows that interventional technique presents an alternative treatment approach for managing foreign bodies within the liver.

摘要

肝脓肿是临床常见疾病,而鱼骨穿透胃壁导致的肝脓肿则较为罕见。在此,我们报告一例67岁华裔男性患者的病例。该患者发热10天,随后入院。实验室检查显示炎症标志物水平升高,血培养鉴定出(此处原文s后内容缺失)。包括腹部超声和增强计算机断层扫描(CT)在内的影像学检查证实左肝叶存在脓肿,同时在肝实质和胃壁内均发现异物。根据患者病史和影像学结果,最终诊断为鱼骨穿透胃壁,导致肝内脓肿及随后的菌血症。患者接受抗感染治疗,随后采用微创介入技术取出鱼骨。该病例表明,介入技术为处理肝脏内异物提供了一种替代治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ce9c/12034346/7152fd6c1c8f/IDR-18-2087-g0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ce9c/12034346/324b10e9029f/IDR-18-2087-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ce9c/12034346/7152fd6c1c8f/IDR-18-2087-g0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ce9c/12034346/324b10e9029f/IDR-18-2087-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ce9c/12034346/7152fd6c1c8f/IDR-18-2087-g0002.jpg

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2
CT diagnosis and laparoscopic treatment of hepatic abscess secondary to fish bone transmigration through the stomach wall.鱼骨经胃壁游走继发肝脓肿的CT诊断与腹腔镜治疗
Radiol Case Rep. 2023 Aug 31;18(11):3975-3978. doi: 10.1016/j.radcr.2023.08.076. eCollection 2023 Nov.
3
Pyogenic liver abscess secondary to gastric perforation of an ingested toothpick: A case report.
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World J Clin Cases. 2023 Aug 16;11(23):5622-5627. doi: 10.12998/wjcc.v11.i23.5622.
4
Laparoscopic Treatment of Hepatic Abscess Caused by an Ingested Foreign Body.腹腔镜治疗因摄入异物导致的肝脓肿
J Minim Invasive Surg. 2019 Dec 15;22(4):177-180. doi: 10.7602/jmis.2019.22.4.177.
5
An unusual cause of pericardial effusion: A case report of a hepatic abscess following foreign body migration and duodenal perforation.心包积液的罕见病因:异物迁移及十二指肠穿孔后肝脓肿一例报告
Int J Surg Case Rep. 2022 Apr;93:106931. doi: 10.1016/j.ijscr.2022.106931. Epub 2022 Mar 9.
6
Liver abscess in the caudate lobe caused by a fishbone and treated by laparoscopy: a case report.腹腔镜治疗尾状叶鱼骨致肝脓肿 1 例报告。
BMC Surg. 2022 Jan 8;22(1):6. doi: 10.1186/s12893-021-01457-z.
7
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Cureus. 2021 Feb 17;13(2):e13403. doi: 10.7759/cureus.13403.
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Development of an abdominal wall abscess caused by fish bone ingestion: a case report.鱼骨吞食导致腹壁脓肿的病例报告
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J Minim Access Surg. 2020 Oct-Dec;16(4):418-420. doi: 10.4103/jmas.JMAS_196_19.
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