Fish-Bone Migration to the Liver Causing Hepatic Abscess: A Scoping Review of Published Cases (2015–2025)

Abstract

Background: Foreign body ingestion is common; however, migration of an ingested fish bone into the liver with subsequent abscess formation is rare, frequently presents with nonspecific abdominal symptoms, and poses a diagnostic challenge in routine clinical practice, often leading to delayed diagnosis. Methods: A scoping review of PubMed, Google Scholar, SciELO, and ScienceDirect identified human case reports and case series (2015–2025) describing confirmed intrahepatic fish-bone migration or penetration causing hepatic abscess. Reports without radiologic or intraoperative confirmation and those involving non–fish-bone foreign bodies were excluded. Extracted data included demographics, migration routes, imaging findings, management, and outcomes. Results: Twenty-seven publications reporting 29 patients met the inclusion criteria, including 25 individual case reports and 2 case series. Presumed transgastric migration was reported in 22 patients (75.9%), and the left hepatic lobe was involved in 20 cases (69.0%). Computed tomography identified a linear radiodense foreign body in 24 patients (82.8%). Surgical or minimally invasive foreign-body removal was performed in 21 patients (72.4%), with generally favorable outcomes, although follow-up reporting was variable. Conclusion: Intrahepatic fish-bone migration is a rare but clinically important cause of hepatic abscess and should be considered in patients with unexplained, particularly left-lobe, hepatic abscesses when CT demonstrates a linear foreign body or when response to standard therapy is atypical; timely source control is usually effective