Liver abscess following ingestion of a foreign object

Abstract

A 31 year old, previously healthy female presented to A&E on 24/07/2012 with a 2 day history of colicky epigastric pain and spiking fever; however on investigation no pathology was found except for an ovarian cyst of 4cm. It was concluded that it was unlikely that the cyst was causing pain and fever and the patient was discharged. She was given proton pump inhibitors for 2 weeks and pain improved, however on stopping therapy, the pain became much more severe, with radiation to the back. She presented to A&E again on 05/08/2012. A more detailed history elicited the fact that she had ingested half a toothpick by mistake 3 weeks previously. Imaging showed the formation of an abscess between the stomach and liver; which needed drainage.