Successfully Treated Intra-Abdominal Abscess Caused by Fish Bone With Perforation of Ascending Colon: A Case Report

Abstract

Ingestion of a foreign body is not uncommon, but rarely results in perforation of the gastrointestinal tract. The most common sites of perforation are reportedly the narrowest parts of the bowel, and perforation of the right side of the colon is rare. We report herein the case of a 69-year-old man who presented with an 8-week history of right upper abdominal pain. Laboratory data revealed inflammation at the first hospital visit. Computed tomography revealed a hypodense lesion containing a hyperdense foreign body in the abdomen. Intra-abdominal abscess caused by foreign body perforation was diagnosed. After administering antibiotics for 2 weeks, surgery was performed. Symptoms had resulted from perforation of the ascending colon by a fish bone. Key words: Fish bone -Colon perforationA ccidental ingestion of a foreign body such as a fish or chicken bone is relatively common. In most cases, the ingested foreign body passes through the gastrointestinal tract uneventfully, and perforation of the bowel by the foreign body reportedly occurs in less than 1% of cases.1 The most common sites of perforation are reportedly the narrowest parts of the bowel, at either the ileocecal valve or recto-sigmoid junction, and perforation of the right side of the colon is rare. 2 We report an unusual case involving perforation of the ascending colon by a fish bone.

Sigmoid Colon Perforation, Pelvic Collection, and Hydronephrosis Caused by an Ingested Chicken Wishbone

“…Diverticular disease predisposes the colon to be susceptible to perforation due to a foreign body, a chicken bone in our case. Patients may intentionally ingest the foreign bodies due to intellectual or mental problems, yet most patients who had unintentional foreign bodies ingested do not recall ingesting them, as was the case for the presented patient [8,9]. Moreover, it was described in the literature the accidental finding of colonic cancer in patients who had foreign body perforation, suggesting that the foreign body might get stuck due to the presence of the colonic mass [10].…”

Case report of abdominal left upper quadrant collection secondary to fish bone perforation

“…The delay in passing the cardia and the duodenum makes correlation with later symptoms difficult, because patients usually do not remember the time of ingestion. In contrast to a gastro-duodenal perforation by a foreign body complicated with chemical peritonitis that is quite symptomatic, a colon perforation may evolve with a sub-acute clinical peritonitis and/or abscess formation; this may mean milder symptoms; adding a significant delay from the intake of the foreign body, the presentation leaves the differential diagnosis open for debate at admission time between emergency room (ER), radiology and surgeons [ 1 , 3 – 6 ]. A case series report about ingested radio-opaque foreign bodies describes a mean time for spontaneous passage through the digestive tract of less than 1 week in 75% of cases, with a mean hospital stay of 3.4 days.…”

“…Most foreign bodies may pass spontaneously through the digestive tract; some of them may need endoscopic extraction while surgery is seldom needed [1,2]. Fish bones are the most frequently ingested organic foreign objects, but complications such as mechanical obstruction or small bowel perforation are rare [2][3][4][5][6].…”

Multiple abdominopelvic abscesses caused by fishbone: A case report of rare etiology and literature review

“…Accidental ingestion of a foreign body, as a fishbone, is relatively common, accounting for 48–88 % of foreign substance consumption cases [ [1] , [2] , [3] ]. Within a week, the majority of foreign objects pass uneventfully through the gastrointestinal tract after being encased in a bolus of food and moved by the intestinal peristaltic contractions [ 4 , 5 ].…”