The pain began as a dull ache in his abdomen. Fever followed. At first glance, doctors saw a common problem—a liver abscess, likely due to infection. They drained the pus, prescribed antibiotics, and sent the 45-year-old man in Saudi Arabia on his way. Case closed, right?

Wrong. The pain came back. This time, it stayed.

After nearly a week of searing abdominal discomfort and high fever, the man returned to the emergency room. What followed was a medical mystery with an unexpected culprit: a wayward fish bone that had journeyed from his gut, pierced through his intestinal wall, and embedded itself in his liver. The case report was published via BMJ Case Reports.

A Bad Gut Feeling

The man first sought care after ten days of pain and a persistent fever. Doctors at the local hospital found a fluid-filled abscess in the right lobe of his liver. Liver abscesses are relatively rare, seen in only about two to 17 out of every 100,000 people each year. They’re typically caused by bacteria from the bile ducts or infections that spread from nearby organs.

In this case, doctors treated the abscess, and the man recovered—briefly. A month later, the pain returned, along with a fever that climbed above 102.4°F (39.1°C). His blood work showed signs of infection: high white blood cell counts and low albumin, a protein made by the liver.

X-rays revealed nothing. But a CT scan told a different story.

The scan showed two distinct anomalies: a second abscess and something far stranger—a thin, twig-like object, just under an inch long, lodged in the central region of his liver. It was the kind of image radiologists don’t soon forget.

Doctors suspected the object had triggered both abscesses. They prescribed antibiotics and scheduled a laparotomy—open abdominal surgery—to retrieve the mysterious item.

What they removed was not a metal shard, a splinter, or a piece of plastic.

It was a fish bone.

Silent, Sharp, and Problematic

The patient didn’t remember anything unusual during meals. But he later recalled eating fish about five months earlier. Somehow, in the a fish bone had slipped past his throat and into the labyrinth of his intestines—without so much as a scratch to give away its presence.

“Most small fish bones which have been eaten pass without any obstruction through the gut in a week or so,” wrote Dr. Ibrahim Masoodi and his colleagues at King Fahad Medical City in their case report. “However, the patient comes to medical attention once migration of the fish bone causes liver abscess.”

The body responded by forming an abscess—a pocket of pus—to fight off infection at the site of injury. The initial antibiotics only treated the symptoms. The foreign object remained, continuing to fester.

Such cases are rare but not unheard of. Medical journals have documented fish bones found in unusual places: piercing hearts, lungs, and even the thyroid. What sets this case apart, however, is the way the liver hid the true culprit until modern imaging and surgery brought it into the light. By the time the man underwent surgery, the infection had flared twice. But after the bone was removed and the abscess drained, his symptoms vanished.

A Recovery Without Complications

After surgery, the man recovered without incident. Follow-up appointments over the next three months showed no signs of lingering infection or new symptoms. The bone, it seems, was the final piece of the puzzle.

His case now joins a memorable list of medical curiosities—and issues a warning, if you’re into fish.

In the report, doctors didn’t issue blanket alarms about eating fish. But the story serves as a reminder that even the most common foods can hide hidden dangers—and that sometimes, the cause of a mysterious illness may be as small and sharp as a fish bone no one saw coming.