Korean J Gastrointest Endosc > Volume 36(6); 2008 > Article
Korean Journal of Gastrointestinal Endoscopy 2008;36(6): 390-394.
이쑤시개에 의한 십이지장 천공과 동반된 간농양 1예
박상준ㆍ이창구ㆍ김상억ㆍ김정현ㆍ이광희ㆍ김기용ㆍ윤진우ㆍ김선영*
동강병원 내과, *병리과
A Case of Liver Abscess Associated with Duodenal Perforation by a Toothpick
Sang Jun Park, M.D., Chang Goo Lee, M.D., Sang Eok Kim, M.D., Jung Hyun Kim, M.D., Kwang Hee Lee, M.D., Ki Yong Kim, M.D., Jin Woo Yun, M.D. and Sun Young Kim, M.D.*
Departments of Internal Medicine and *Pathology, Dongkang Hospital, Ulsan, Korea
Abstract
The ingestion of foreign bodies into the gut is rather common. Most these foreign bodies are passed out spontaneously without complications. Our patient was hospitalized for fever, nausea and vomiting for one week. On the initial endoscopic examination, a toothpick was seen to be impacted in the wall of the duodenal bulb. Air bubbles were noted at the site where the toothpick was removed. The duodenal perforation was treated with endoscopic hemoclipping. Abdominal CT showed free air in the periduodenum and there was a liver abscess. Therefore, liver abscess associated with duodenal perforation by the toothpick was diagnosed. On the cytology of the aspirated materials from the liver abscess, sulfur granule formation was noted and hepatic actinomycosis was diagnosed. The liver abscess was successfully treated with CT-guided abscess drainage and antibiotics. We report here on an unusual case of a liver abscess associated with duodenal perforation by a toothpick, along with a review of the literature. (Korean J Gastrointest Endosc 2008;36:390-394)
Key Words: Toothpick, Duodenal perforation, Liver abscess, Actinomycosis
주요어: 이쑤시개, 십이지장 천공, 간농양, 방선균증
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