Hepatic Abscess from Ingested Foreign Body: Clinical Features and Diagnostic Challenges—A Systematic Review of Current Reported Cases

Abstract

Introduction

Hepatic abscess resulting from ingested foreign bodies is a rare but potentially life-threatening condition, often leading to delayed diagnosis and complications. This systematic review summarizes the clinical characteristics, diagnostic approaches, and outcomes of reported cases.

Method

We searched electronic databases (MEDLINE, OVID, EMBASE) for case reports and case series published through December 2024, describing hepatic abscesses with a visualized foreign body within the abscess. We excluded cases where the foreign body was not confirmed visually within the abscess either radiologically or surgically. Data on demographics, clinical presentation, imaging, microbiology, treatment, and outcomes were extracted. Descriptive statistics were used to summarize the data.

Results

We included 167 studies (178 cases). The mean age was 56 years (62% male). The common presenting symptoms included abdominal pain (83%) and fever (78%). Fishbone was the most common foreign body (51%). The most commonly isolated organisms were Streptococcus species. The majority required antibiotics and surgery. Descriptive results are presented regarding the perforation sites as well as details of case record.

Conclusion

Clinicians should be aware of hepatic abscesses from ingested foreign bodies, particularly if other sources of infection have been excluded and foreign bodies are not visible on the radiography or even without a history of foreign body ingestion. Radiological confirmation of a foreign body is critical for diagnosis.