Suenghataiphorn Thanathip, Tribuddharat Narisara, Danpanichkul Pojsakorn, Kulthamrongsri Narathorn
Department of Internal Medicine, Griffin Hospital, Derby, CT, United States.
St. Elizabeth Medical, Boston, MA, United States.
J Clin Exp Hepatol. 2025 Sep-Oct;15(5):102586. doi: 10.1016/j.jceh.2025.102586. Epub 2025 Apr 29.
Hepatic abscess resulting from ingested foreign bodies is a rare but potentially life-threatening condition, often leading to delayed diagnosis and complications. This systematic review summarizes the clinical characteristics, diagnostic approaches, and outcomes of reported cases.
We searched electronic databases (MEDLINE, OVID, EMBASE) for case reports and case series published through December 2024, describing hepatic abscesses with a visualized foreign body within the abscess. We excluded cases where the foreign body was not confirmed visually within the abscess either radiologically or surgically. Data on demographics, clinical presentation, imaging, microbiology, treatment, and outcomes were extracted. Descriptive statistics were used to summarize the data.
We included 167 studies (178 cases). The mean age was 56 years (62% male). The common presenting symptoms included abdominal pain (83%) and fever (78%). Fishbone was the most common foreign body (51%). The most commonly isolated organisms were Streptococcus species. The majority required antibiotics and surgery. Descriptive results are presented regarding the perforation sites as well as details of case record.
Clinicians should be aware of hepatic abscesses from ingested foreign bodies, particularly if other sources of infection have been excluded and foreign bodies are not visible on the radiography or even without a history of foreign body ingestion. Radiological confirmation of a foreign body is critical for diagnosis.
摄入异物导致的肝脓肿是一种罕见但可能危及生命的疾病，常导致诊断延迟和并发症。本系统评价总结了已报道病例的临床特征、诊断方法和结局。
我们检索了电子数据库（MEDLINE、OVID、EMBASE），以查找截至2024年12月发表的病例报告和病例系列，这些报告描述了脓肿内有可视化异物的肝脓肿。我们排除了在脓肿内未通过放射学或手术在视觉上确认异物的病例。提取了关于人口统计学、临床表现、影像学、微生物学、治疗和结局的数据。使用描述性统计来总结数据。
我们纳入了167项研究（178例病例）。平均年龄为56岁（男性占62%）。常见的症状包括腹痛（83%）和发热（78%）。鱼骨是最常见的异物（51%）。最常分离出的微生物是链球菌属。大多数患者需要抗生素治疗和手术。呈现了关于穿孔部位以及病例记录细节的描述性结果。
临床医生应意识到摄入异物导致的肝脓肿，特别是在排除了其他感染源且在放射影像学上未见异物甚至没有异物摄入史的情况下。异物的放射学确认对诊断至关重要。
