Liver Abscess Caused by a Foreign Body: Management by Minimally Invasive Ultrasound-guided Drainage
VWT Chan, WK Wong, SKY Kwok, KW Tang
Hong Kong J Radiol 2014;17:267-70
DOI: 10.12809/hkjr1413226
Complications of foreign body ingestion are infrequently encountered in clinical practice. Less than 100 cases of liver abscess formed secondary to foreign body penetration of the stomach have been reported in the English literature. Previous reported cases have been predominantly managed surgically; ultrasound-guided drainage as primary treatment has not been reported. We report the first case of liver abscess caused by foreign body ingestion in Hong Kong managed with ultrasound-guided drainage, without surgical treatment. Although rare, prompt recognition of this condition for early intervention is necessary, as delayed or missed diagnosis may be associated with significant morbidity or death. We also discuss the use of multiplanar reformatting of computed tomography to identify the causative agent, if any, and its exact location in relationship to other anatomical structures. This aids endoscopic removal of the foreign body in a minimally invasive fashion.
中文摘要
由異物引起的肝膿腫：微創超聲引導下的引流
陳煒達、王旺根、郭欣、鄧國穎
臨床上很少遇到因吞食異物引致併發症的病例。英文文獻報導因異物穿透胃壁繼發肝膿腫形成的病例不足100例。以往報導病例主要採取手術治療；超聲引導下引流作為首要治療的個案則未有報導。本文報告首例由異物引發肝膿腫並採用超聲引導下引流，而非外科手術為治療方案的香港病例。雖然少見，類似個案應及時診斷以便早期治療，否則延誤或漏診可能引發嚴重疾病甚至死亡。本文也討論了使用電腦斷層掃描的多平面重建功能來確定致病物的存在（如有的話）及其相對於其他解剖結構的確切位置，這有助以微創形式於內窺鏡下異物移除。