{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T17:50:54Z","timestamp":1782323454181,"version":"3.54.5"},"reference-count":18,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"C","license":[{"start":{"date-parts":[[2022,4,1]],"date-time":"2022-04-01T00:00:00Z","timestamp":1648771200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2022,4,1]],"date-time":"2022-04-01T00:00:00Z","timestamp":1648771200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2022,3,8]],"date-time":"2022-03-08T00:00:00Z","timestamp":1646697600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction and importance:<\/jats:title>\n                    <jats:p>Although foreign bodies are a rare cause of gastrointestinal tract perforation, they may serve as a nidus for hepatic abscess. Abdominal pain is the most common presenting symptom. We present a case of an ingested pen causing duodenal perforation and hepatic abscess several months after initially presenting with a pericardial effusion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation:<\/jats:title>\n                    <jats:p>A 59-year-old female living in an intensive tertiary mental health facility was noted to have an incidental pericardial effusion during work-up for hyponatremia. Seven months later, she developed a new fever and was noted to have interval increase in the pericardial effusion size. This prompted further investigation which finally revealed that an ingested pen had perforated through the first part of the duodenum and caused an abscess in the left lobe of the liver. The pericardial effusion was presumed secondary to local inflammation. Upon discovery of the abscess, the patient underwent successful operative management including abscess drainage, foreign body extraction, and duodenal repair.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical discussion:<\/jats:title>\n                    <jats:p>Reports of hepatic abscess from foreign body causing duodenal perforation are rare, with bone fragments and toothpicks the most common foreign bodies implicated. There is one other previously reported case of an ingested pen. Abdominal pain is present in up to 85% of cases, but fever may be the only presenting symptom.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Foreign body migration causing a hepatic abscess may present non-specifically with unexplained fever or even pericardial effusion. Psychiatric comorbidities may contribute to delays in diagnosis due to difficulties recalling the episode of ingestion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Highlights<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1016\/j.ijscr.2022.106931","type":"journal-article","created":{"date-parts":[[2022,3,9]],"date-time":"2022-03-09T12:24:43Z","timestamp":1646828683000},"page":"106931","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":6,"title":["An unusual cause of pericardial effusion"],"prefix":"10.1097","volume":"93","author":[{"given":"Tyler D.","family":"Yan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philemon H.Y.","family":"Leung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles","family":"Zwirewich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alison","family":"Harris","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Chartier-Plante","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R2-43-20260304","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1097\/MD.0b013e3181d41c38","article-title":"Migrated foreign body liver abscess: illustrative case report, systematic review, and proposed diagnostic algorithm","volume":"89","author":"Leggieri","year":"2010","journal-title":"Medicine (Baltimore"},{"key":"R3-43-20260304","doi-asserted-by":"crossref","first-page":"563","DOI":"10.1097\/01.mop.0000245359.13949.1c","article-title":"Foreign bodies in the gastrointestinal tract","volume":"18","author":"Wylie","year":"2006","journal-title":"Curr. Opin. Pediatr"},{"key":"R4-43-20260304","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1155\/1997\/815876","article-title":"Occult liver abscess following clinically unsuspected ingestion of foreign bodies","volume":"11","author":"Tsui","year":"1997","journal-title":"Can. J. Gastroenterol"},{"key":"R5-43-20260304","doi-asserted-by":"crossref","first-page":"922","DOI":"10.1007\/BF02482788","article-title":"Successful treatment of a hepatic abscess that formed secondary to fish bone penetration by percutaneous transhepatic removal of the foreign body: report of a case","volume":"29","author":"Horii","year":"1999","journal-title":"Surg. Today"},{"key":"R6-43-20260304","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1016\/j.ijsu.2020.10.034","article-title":"The SCARE 2020 guideline: updating consensus Surgical CAse REport (SCARE) guidelines","volume":"84","author":"Agha","year":"2020","journal-title":"Int. J. Surg"},{"key":"R7-43-20260304","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1016\/j.ijscr.2015.07.013","article-title":"An unusual case of duodenal perforation caused by a blister pack: a case report and literature review","volume":"14","author":"Yao","year":"2015","journal-title":"Int. J. Surg. Case Rep"},{"key":"R8-43-20260304","doi-asserted-by":"crossref","first-page":"885","DOI":"10.1007\/s11605-011-1711-7","article-title":"Pyogenic hepatic abscess secondary to endolumenal perforation of an ingested foreign body","volume":"16","author":"Glick","year":"2012","journal-title":"J. Gastrointest. Surg"},{"key":"R9-43-20260304","doi-asserted-by":"crossref","first-page":"1466","DOI":"10.3748\/wjg.v13.i9.1466","article-title":"Hepatic abscess induced by foreign body: case report and literature review","volume":"13","author":"Santos","year":"2007","journal-title":"World J. Gastroenterol"},{"key":"R10-43-20260304","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1186\/1471-2482-3-8","article-title":"Liver abscess secondary to a broken needle migration- a case report","volume":"3","author":"Chintamani","year":"2003","journal-title":"BMC Surg"},{"key":"R12-43-20260304","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1097\/00063110-200502000-00012","article-title":"A rooster's revenge: hepatic abscess caused by a chicken bone","volume":"12","author":"Starakis","year":"2005","journal-title":"Eur. J. Emerg. Med"},{"key":"R13-43-20260304","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1097\/PAF.0000000000000617","article-title":"The importance of autopsy in a case of digestive perforation undetected by postmortem computed tomography","volume":"42","author":"Macoin","year":"2021","journal-title":"Am. J. Forensic Med. Pathol"},{"key":"R14-43-20260304","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1046\/j.1440-1673.1999.433670.x","article-title":"Life-threatening pica: liver abscess from perforating foreign body","volume":"43","author":"Perkins","year":"1999","journal-title":"Australas. Radiol"},{"key":"R15-43-20260304","doi-asserted-by":"crossref","first-page":"135","DOI":"10.4330\/wjc.v3.i5.135","article-title":"Diagnosis and management of pericardial effusion","volume":"3","author":"Sagrist\u00e0-Sauleda","year":"2011","journal-title":"World J. Cardiol"},{"key":"R16-43-20260304","first-page":"42","article-title":"Liver abscess secondary to duodenal perforation by fishbone: report of a case","volume":"108","author":"Jim\u00e9nez-Fuertes","year":"2016","journal-title":"Rev. Esp. Enferm. Dig"},{"key":"R17-43-20260304","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1097\/00000433-200103000-00018","article-title":"Hepatic abscess formation and unexpected death: a delayed complication of occult intraabdominal foreign body","volume":"22","author":"Byard","year":"2001","journal-title":"Am. J. Forensic Med. Pathol"},{"key":"R18-43-20260304","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1002\/bjs.18004217620","article-title":"Liver abscess due to foreign-body migration from the alimentary tract; a report of two cases","volume":"42","author":"Griffiths","year":"1955","journal-title":"Br. J. Surg"},{"key":"R19-43-20260304","doi-asserted-by":"crossref","first-page":"1018","DOI":"10.1007\/s00595-007-3524-6","article-title":"Ruptured hepatic abscess caused by fish bone penetration of the duodenal wall: report of a case","volume":"37","author":"Kadowaki","year":"2007","journal-title":"Surg. Today"},{"key":"R20-43-20260304","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1016\/j.jviscsurg.2015.01.007","article-title":"Pyogenic liver abscess: an unusual cause","volume":"152","author":"Dinnoo","year":"2015","journal-title":"J. Visc. Surg"}],"container-title":["International Journal of Surgery Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2210261222001778?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2210261222001778?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.lww.com\/10.1016\/j.ijscr.2022.106931","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T10:01:33Z","timestamp":1772618493000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1016\/j.ijscr.2022.106931"}},"subtitle":["A case report of a hepatic abscess following foreign body migration and duodenal perforation"],"short-title":[],"issued":{"date-parts":[[2022,4]]},"references-count":18,"journal-issue":{"issue":"C","published-print":{"date-parts":[[2022]]}},"URL":"https:\/\/doi.org\/10.1016\/j.ijscr.2022.106931","relation":{},"ISSN":["2210-2612"],"issn-type":[{"value":"2210-2612","type":"print"}],"subject":[],"published":{"date-parts":[[2022,4]]}}}