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. 2024 Sep 23;18(1):431-438.
doi: 10.1159/000541081. eCollection 2024 Jan-Dec.

Colonic Fishbone-Induced Perforation Involving a Penile Colorectal Carcinoma: A Case Report

Akira Imoto  1   2 , Yuki Nagata  3 , Yoshinori Shinohara  1   2 , Hirota Miyazaki  1   2 , Masanobu Fukumoto  1   2 , Hidehiro Kitae  1   2 , Masateru Asada  3 , Masafumi Noda  3 , Kaoru Okada  3 , Akira Asai  2 , Kazuhide Higuchi  1   2 , Hiroki Nishikawa  2
Affiliations

Colonic Fishbone-Induced Perforation Involving a Penile Colorectal Carcinoma: A Case Report

Akira Imoto et al. Case Rep Gastroenterol. .

Abstract

Introduction: Fishbone (FB) ingestion is a rare cause of gastrointestinal perforation. Herein, we report a case of FB-induced colonic perforation, in which the presence of a penile colonic carcinoma may have contributed to the development of the perforation.

Case presentation: An 83-year-old man was admitted to our hospital with severe abdominal pain during bowel movement. Computed tomography (CT) yielded a diagnosis of sigmoid colonic perforation due to FB and secondary peritonitis. Preoperative endoscopic examination suggested that the perforation was associated with a stalked colon tumor in the vicinity. After undergoing low anterior resection and sigmoid colostomy, the patient is currently doing well.

Conclusion: The incidence of FB-induced colorectal-cancer-related perforation is expected to increase in the future owing to an aging society, the increase in the rates of colorectal cancer, and increase in fish consumption. This rare case suggests that preoperative examinations are important and that even relatively small polyps can contribute to gastrointestinal perforation caused by FBs. Older individuals should exercise caution during fish ingestion.

Keywords: Colorectal carcinoma; Fishbone; Penile polyp; Perforation.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

Fig. 1.
Fig. 1.
CT shows a 40-mm-long linear structure with a high-density signal (arrows) in the axial (a) and sagittal (b) sections. The intestinal wall near the highly dense structure was thickened, and the surrounding fatty tissue concentration was elevated. No obvious tumors were observed.
Fig. 2.
Fig. 2.
a Abdominal US revealed a high echoic linear structure that did not change shape in the peristaltic intestinal tract (arrows). b A portion of the epithelial tumor is barely visible within the adherent sigmoid colon (arrowheads). This mass was suspected to be mobile because it came out and retracted and later turned out to be colonic cancer. c A mass (arrow heads) with a stalk (arrows) in the rectosigmoid colon was identified. No obvious leakage of contrast media was observed. C, cecum; S, sigmoid colon; R, rectum.
Fig. 3.
Fig. 3.
Surgical specimen. a A 20-mm head-sized red mass (arrow heads) with a thick stalk (white arrows) was observed in the distal sigmoid colon. A perforation point was present in the immediate vicinity of the polyp. b The removed FB was 35 mm long. c The FB protruding outside the serosa from the sigmoid colon (white arrows) reached the mesorectum of the contralateral rectum (yellow arrow). S, sigmoid colon; R, rectum; O, oral side; A, anal side.
See this image and copyright information in PMC

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