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. 2022 Jun:95:107157.
doi: 10.1016/j.ijscr.2022.107157. Epub 2022 May 4.

Conservative management of fish bone-induced large bowel perforation: Case report

Raja Husain  1 , Deena Ahmed Alghamdi  2 , Fatimah Ali Ghzoi  2 , Sarah Khaled AlArafah  3 , Manar Abubaker Bahammam  4 , Mohammed Al Duhileb  5
Affiliations

Conservative management of fish bone-induced large bowel perforation: Case report

Raja Husain et al. Int J Surg Case Rep. 2022 Jun.

Abstract

Introduction: Fish bone ingestion is one of the common medical complaint. Most foreign bodies passed safely through gastrointestinal tract (GIT) without any complications. The clinical presentation of foreign body ingestion is similar to other conditions such as diverticulitis. Most literatures focus on the surgical management of complications secondary to fish bone ingestion. In this case we report a case of an elder patient with complain of progressive abdominal pain.

Presentation of case: 71-year-old female, admitted to surgical ward with the complain of progressive abdominal pain. Physical examination revealed right upper quadrant tenderness with normal digital rectal examination. An abdominal X-ray was obtained and was not remarkable. Computed tomography (CT) chest, abdomen, and pelvis with contrast revealed proximal transverse colon wall thickening with reginal soft tissue thickening, inflammation and a radiopaque foreign body. Patient was managed conservatively by bowel rest, and antibiotics.

Discussion: Fish bone swallowing account for two third of these foreign bodies. Most of the foreign bodies pass through the gastrointestinal tract (GIT)without any significant harm or complications. The clinical presentation of perforation secondary to fish bone is nonspecific which may delay the diagnosis. The management can be either medical or surgical depend on many factors.

Conclusion: Although, foreign body ingestion is one of the common complaints in the medical practice, its complications is extremely uncommon. However, improvement of medical imaging increased sensitivity and specify in detecting fish bone.

Keywords: Case report; Conservative; Fish bone; Large bowel; Perforation.

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Conflict of interest statement

No conflict of interest to declare.

Figures

Fig. 1
Fig. 1
Abdominal CT showed impacted fish bone in the transverse colon.
See this image and copyright information in PMC

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