Angry Bird's Revenge: Hepatic Abscesses Secondary to Colonic Perforation

  • Gholamreza Sivandzadeh Department of Gastroenterology, Gastroenterology and Hepatology Research Center, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.
  • Alimohammad Banazadeh Department of Surgery, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.
  • Amir Anushiravani Department of Gastroenterology and Hepatology, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Keywords: Chicken bone, Perforation, Liver abscess


Foreign bodies are commonly ingested and usually pass through the gastrointestinal tract, but in less than 1% complications can be seen. We aimed to report a very rare case of multiple hepatic abscesses caused by perforation of the sigmoid colon due to a chicken bone. An 82-year-old man presented with a 5-day history of abdominal pain, fever, and coffee ground vomiting. He was febrile and tachycardic and had a mild localized abdominal tenderness in the left lower quadrant. Laboratory findings revealed a lymphocyte dominant leukocytosis with an elevated erythrocyte sedimentation rate. Multiple abscesses were shown in the right lobe of the liver in abdominal computed tomography. Colonoscopy showed a chicken bone perforating both walls of the sigmoid colon. He received broad-spectrum antibiotics and underwent surgery for a complete recovery. Chronic lymphocytic leukemia was diagnosed by flow cytometry phenotyping. Mortality and morbidity of hepatic sepsis caused by foreign body-induced colon perforation depend on a rapid diagnosis.  We presented a very rare condition that should always be kept in mind when dealing with a case of liver abscess and even while confronting septic shock with an unknown origin.


Fosi, S., Altobelli, S., Bindi, A., Villa, M., Sanctis, F. D., Montuori, M., Simonetti, G., etal. Gradual Colonic Impaction of a Chicken Bone Associated with Inflammatory Pseudotumor Formation and Nonocclusive Colon Ischemia. Case Reports in Radiology 2014, 1-7. doi:10.1155/2014/215465

Chong, L. (2014). Successful treatment of liver abscess secondary to foreign body penetration of the alimentary tract: A case report and literature review. World Journal of Gastroenterology, 20(13), 3703. doi:10.3748/wjg.v20.i13.3703

Gundara, J. S., & Harrison, R. (2010). An Unusual Zoonosis: Liver Abscess Secondary to Asymptomatic Colonic Foreign Body. HPB Surgery, 2010, 1-3. doi:10.1155/2010/794271

Santos, S. A. (2007). Hepatic abscess induced by foreign body: Case report and literature review. World Journal of Gastroenterology, 13(9), 1466. doi:10.3748/wjg.v13.i9.1466

F. Clarenc¸on, O. Scatton, E. Brugui`ere et al., “Recurrent liver abscess secondary to ingested fish bone migration: report of a case,” Surgery Today, vol. 38, no. 6, pp. 572–575, 2008.

Joglekar, S., Rajput, I., Kamat, S., & Downey, S. (2009). Sigmoid perforation caused by an ingested chicken bone presenting as right iliac fossa pain mimicking appendicitis: A case report. Journal of Medical Case Reports, 3(1), 7385. doi:10.4076/1752-1947-3-7385

C., Singhal, V., Lubhana, P., Durkhere, R., & Bhandari, S. (2003). Liver abscess secondary to a broken needle migration- A case report. BMC Surgery BMC Surg, 3(1). doi:10.1186/1471-2482-3-8

Theodoropoulou, A., Roussomoustakaki, M., Michalodimitrakis, M. N., Kanaki, C., & Kouroumalis, E. A. (2002). Fatal hepatic abscess caused by a fish bone. The Lancet, 359(9310), 977. doi:10.1016/s0140-6736(02)07999-0

How to Cite
Sivandzadeh G, Banazadeh A, Anushiravani A. Angry Bird’s Revenge: Hepatic Abscesses Secondary to Colonic Perforation. Acta Med Iran. 56(2):127-131.
Case Report(s)