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Case Reports
. 2024 Oct 22;16(10):e72099.
doi: 10.7759/cureus.72099. eCollection 2024 Oct.

Fishbone Foreign Body Ingestion With Gastric Impaction and Intestinal Micro-perforation in an Adult Female: A Case Report

David H Dupont  1 , Louis Maria Umejiego  2 , Savni Satoskar  3 , Nfn Soumya  3 , Marcos Rosa Santana  3 , Anshuman Sikka  3 , Nitsuh Ayele  3 , Cesar Riera Gonzalez  3 , Nivard Bahadur  3 , Ajit Singh  3
Affiliations
Case Reports

Fishbone Foreign Body Ingestion With Gastric Impaction and Intestinal Micro-perforation in an Adult Female: A Case Report

David H Dupont et al. Cureus. .

Abstract

Foreign body ingestion of fishbones is a very common complaint where most foreign bodies travel safely through the gastrointestinal tract (GIT) without any serious complications. However, its clinical presentation is nonspecific, and its clinical severity can vary widely, thus requiring the use of conservative and or invasive treatment modalities. In this case report, we present a case of a 42-year-old female who reported eating fish two days prior to presenting with upper gastrointestinal tract (GIT) foreign body impaction in addition to a lower GIT micro-perforation secondary to fishbone ingestion, both of which were successfully managed with conservative, nonsurgical treatment modalities. Impaction, perforation, or obstruction of fishbone foreign bodies often occur at GIT angulations or narrowing. Clinical diagnosis of foreign body ingestion requires the use of multiple modalities such as a detailed history, physical exam, radiographic evaluation, and endoscopic evaluation as needed. Treatment depends on multiple factors and can be conservative or surgical in nature. Fishbone foreign body ingestion is a common complaint and rarely leads to severe complications. However, its diagnosis can be difficult without an explicit history highlighting ingestion of fishbones and requires the use of appropriate imaging modalities such as computed tomography (CT) scans. Subsequent management may require conservative or invasive treatment modalities based on the location of the fishbone, and the presence or absence of accompanying complications such as peritoneal signs, sepsis, and radiographic identification of bowel perforation.

Keywords: fishbone; fishbone foreign body ingestion; fishbone impaction; fishbone injury; foreign body ingestion in adults; gastroenterology and endoscopy; lower gastrointestinal tract; micro-perforation; surgical case report; upper gastrointestinal tract.

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Conflict of interest statement

Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Initial CT scan showing gastric and jejunal foreign bodies
Figure 2
Figure 2. Repeat CT scan on admission day 2 showing a foreign body in the ascending colon
Figure 3
Figure 3. Esophagogastroduodenoscopy demonstrating impaction of two fishbones in the stomach, at the greater curvature and the gastric antrum.
Esophagogastroduodenoscopy (EGD) demonstrating (A) impaction of two fishbones in the stomach. (B) One fishbone at the greater curvature. (C) One fishbone at the gastric antrum
Figure 4
Figure 4. Colonoscopy images demonstrating impaction of multiple fishbones within the ascending colon
Figure 5
Figure 5. Fishbone foreign bodies removed from the stomach and colon
Fishbone foreign bodies removed from the stomach (A) and colon (B), respectively
Figure 6
Figure 6. Jejunal fishbone now entirely displaced into the mesenteric fat
Figure 7
Figure 7. A 3.5 cm retained fishbone within the distal small bowel in the RLQ extending to the adjacent mesenteric fat
RLQ: Right lower quadrant
See this image and copyright information in PMC

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