Accidental ingestion of foreign bodies is a relatively common situation, in the large majority of cases being followed by an unobserved passing of the objects through the digestive tract and their elimination in about a week. We present a patient with liver actinomycosis developed in relation with a gastric (antral) perforation secondary to accidental foreign body ingestion. The complexity of the case raised many problems concerning the imaging diagnosis, especially due to the pseudotumoral aspect of the liver lesion, which extensively involved the retroperitoneal area, the stomach and the pancreas. However, the presence of an image suggesting a foreign body into the gastric wall, in correlation with clinical, biological, morphological and imaging studies solved the case.