A Case of Thoracolumbar Subfascial Abscess Caused by Migration of an Accidentally Swallowed Fish Bone

Abstract

An83-year-oldmanpresentingwithfeverandswellingoftherightthoracolumbarregionwasadmitted to the department of internal medicine in our hospital. Intramuscular abscess was suspected by a computedtomography(CT)scanandhewasreferredtoourdepartmentofsurgery.Afteranaspiration drainageandadministrationofantibacterialagents,hissymptomsimprovedbutrecurred3weekslater. Weperformedpercutaneousdrainageoftheabscess.Asafishboneintheabscesswasdemonstratedret-rospectivelyonCT,weremoveditunderspinalanesthesia.Hispostoperativecoursewasuneventful.A colonoscopicexaminationrevealedmultiplediverticulaintheascendingcolonandlocalizededematousmucosawithaninflammatorypolyplikelesioninthehepaticflexure.Weconsideredthattheingestedfish bonehadpassedthroughthecolonicwall,migratedtotheretroperitoneumfurtherunderrightthoracolumbarfascia,anddevelopedabscess.Therearesomecasesinwhichafishbonepenetratedthegastrointestinaltract,butitisrarethatafishbonereachedthedorsalmuscle.