Fish bone perforation of the small bowel: A case report

Abstract

Introduction Fish bone is one of the most common accidently ingested foreign bodies. Normally, it is eliminated from the gastrointestinal (GI) system without any symptomatology, only 1% of the cases will develop a perforation of the GI tract requiring surgical intervention. Presentation of case A 70-year-old man, presented with a 48h evolving abdominal pain, important abdominal distension, nausea, vomiting, and a last bowel movement reported 2 days ago, The abdomino-pelvic CT-scan objectified a distension of the terminal ileum measured at 30mm, The exploration revealed a sharp foreign body,at the 15 proximal centimeters of the terminal ileum, which penetrated through the wall of the ileum. The foreign body was removed and we noticed that it is a fish bone. The patient recovered well. Discussion Clinical manifestations are determined by the location of the perforation and the preoperative diagnosis is always difficult to reach. Computed tomography (CT) scan is the indicated method to identify ingested foreign bodies and surgery is the treatment of choice. Conclusion Delay in diagnosis and treatment can be associated with significant morbidity and mortality.

Ileal perforation by accidentally ingested animal bone - rare cause of acute abdomen

“…Some authors recommend Non-surgical management for limited cases. This treatment consists of intravenous fluid, nutrition support, antibiotics, and other supportive therapy and depends on the size and the location of perforation, time of diagnosis, patient condition, and contamination degree [6,12].…”

Management of Gastrointestinal Foreign Bodies with Brief Review of the Guidelines

“…Perforation, extraluminal migration, abscess, peritonitis, fistula, appendicitis, necrotizing fasciitis, liver, bladder, heart, and lung penetration, incarcerated umbilical hernia, common carotid artery rupture, aortoesophageal fistula, and death can result from the ingestion of pins, sewing needles, and safety pins, nails, screws, toothpicks, and bone [ 37 38 39 40 41 42 43 44 45 46 47 48 49 ]. The average transit time of an object in children is 3.6 days, while the average perforation time is 10.4 days [ 1 2 ].…”