Pyogenic hepatic abscess secondary to gastric perforation caused by an ingested fish bone

An 88‐year‐old woman presented with 2 months of right upper quadrant pain, weight loss, and 3 days of fevers. Computed tomography scan of her abdomen demonstrated a 5.8 × 5.4 cm peripherally enhancing lesion (Figure, blue arrow) with a linear radiodensity suggestive of a fish bone traversing the gastric antrum and migrating into the liver (Figure, red arrow). Removal of the fish bone laparoscopically, drainage of the abscess, and 8 weeks of antibiotic therapy for Streptococcus constellatus cultured intraoperatively resulted in cure. Prompt recognition and surgical excision of the foreign body, with drainage of the abscess and appropriate antibiotic therapy are crucial for cure.1