Fish bone-induced hepatic abscess: medical treatment

Ng CT, Htoo A, Tan SY
Correspondence: Dr Tan Swee Yaw, tan.swee.yaw@nhcs.com.sg

ABSTRACT
We report a case of a 59-year-old man admitted for acute myocardial infarction. He subsequently spiked a high-grade fever on the second day after percutaneous coronary intervention. Computed tomography imaging of the abdomen revealed a hepatic abscess secondary to gastrointestinal perforation by a fish bone. Medical therapy with antibiotics was preferred over surgical drainage of the hepatic abscess in view of the fact that the patient was on dual antiplatelet agents. The hepatic abscess was completely resolved with conservative antimicrobial therapy. Antimicrobial therapy appears to be a viable option in selected patients with hepatic abscess secondary to fish bone perforation, especially if they have contraindications to surgery.

Keywords: acute myocardial infarction, fish bone, gastrointestinal perforation, hepatic abscess
Singapore Med J 2011; 52(3): e56-e58