A 60-year-old female patient was referred for a massive pyogenic liver abscess that had been initially treated with percutaneous drainage and antibiotics. CT-scan showed a foreign body in the hepatic pedicle, adjacent to the right portal vein: a fishbone. After 6 weeks of medical management with antibiotics, the foreign body was removed laparoscopically. The presence of a foreign body should be sought in cases of pyogenic liver abscess, especially if no other intra-abdominal cause has been found or if the abscess fails to resolve with medical treatment alone.
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