A Case of Sigmoid Colon Perforation by Ingested Fish Bone

Abstract

Fish bones account for a large proportion of foreign bodies in the gastrointestinal tract in Japan, and surgical intervention is often required in case of gastrointestinal perforation. Here we report a case of sigmoid colon perforation by a fish bone. The case was an 86-year-old female. She was admitted to our hospital with a chief complaint of abdominal pain, diarrhea and vomiting. CT examination revealed a linear foreign body with high-density signal at the sigmoid colon, and we diagnosed sigmoid colon perforation caused by it. Intraoperative findings revealed perforation of the sigmoid colon and abscess, so we performed drainage of the abscess cavity and ileostomy in addition to excision and anastomosis of the perforation. There are 38 reports of colon perforation due to fish bones in Japan, including the present case, which are more common in males, and the perforation sites tend to be in the transverse colon and sigmoid colon. About 90% of cases in which abscess or ascites was suspected by preoperative CT examination required surgical treatment. Artificial anus creation tends to be performed in elderly patients, patients with panperitonitis before surgery, and patients with ascites or abscess on preoperative CT examination or intraoperative findings.