Slovenská chirurgia 1/2012

Foreign body as a cause of late recognised intraabdominal infection

Hepatic abscess due to perforation of the gastrointestinal tract caused by ingested foreign bodies is a rare complication, only 46 of cases were publicated in literature. Pre-operative diagnosis is difficult because of negative anamnesis of the accident, because perforation and migration pass of latent and symptoms can manifest aftre months, or years. The best diagnostic method according to literature in this case is CT. The authors report a case of 57-year-old man who was admitted with fever, shivers, diarrhoe, and dyspepsia with CT finding of hepatal abscess of unknown origin. Fifteen centimeters long wooden stick was found in the abscess cavity during surgery, which has patient swallowed half an year ago. Gastroscopy didn´t release perforation of gastrointestinal tract. Latent course of penetrating injury followed by abscessus of liver with occasional fever manifested until half an year and it eventuated in sepic shock. Imaging technique has failed in this case of diagnostic of foreigh body, which was found in the peroperative period. The patient recovered after evacuation of abscess and flushing drainage and he was released on 19. postoperative day.

Keywords: foreign body, perforatio of gastrointestinal tract, liver abscess, late diagnostic.