BÁO CÁO CA BỆNH: ÁP XE GAN DO DỊ VẬT ĐƯỜNG TIÊU HÓA DI TRÚ

Abstract

Introduction: Liver abscess secondary to migrated ingested foreign bodies is a rare entity. The accurate preoperative diagnosis of this condition remains a challenge because almost all patients cannot recall such an event of ingestion. We report two cases of hepatic abscess due to gastrointestinal foreign bodies penetrating the wall of the stomach and the duodenum, in which, one patient developed septic shock. 

Methods: Case series.

Results: From December 2022 to August 2023, we admitted 2 cases of hepatic abscess due to gastrointestinal foreign bodies. Both cases were correctly diagnosed with abdominal CT including identifying liver abscess and the location of the radiopaque foreign body as well as other complications along their migration path. They were successfully treated with resuscitation, foreign body removal, abscess drainage, and broad-spectrum antibiotics and discharged after 2-3 weeks.

Conclusions: The vast majority of swallowed objects pass through the gastrointestinal tract without causing any problems. However, they can lodge and induce inflammation and ulceration and eventually lead to severe complications such as obstruction, perforation, fistula formation, abdominal abscess formation, septic shock, or even death. These cases underscore the importance of considering gastrointestinal foreign bodies as a potential cause of liver abscess, even when patients cannot recall such an event. Timely diagnosis and intervention contribute to successful outcomes in these challenging cases. The interpretation of imaging modalities, especially computed tomography, can identify radiopaque foreign objects with high sensitivity and some non-radiopaque ones, their exact locations, and complications.