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Case Reports
. 2025 Feb 1;17(2):e78362.
doi: 10.7759/cureus.78362. eCollection 2025 Feb.

Appendicular Perforation Caused by a Fishbone: A Case Report

Sophia Bee Ting Tan  1 , Heng-Chin Chiam  1
Affiliations
Case Reports

Appendicular Perforation Caused by a Fishbone: A Case Report

Sophia Bee Ting Tan et al. Cureus. .

Abstract

Foreign body ingestion is a common clinical occurrence, with most objects passing through the gastrointestinal tract uneventfully. However, sharp foreign bodies, such as fishbones, pose a significant risk for complications, including perforation and appendicitis. We present the case of a 48-year-old man who presented with a one-week history of progressively worsening lower abdominal and right lower quadrant pain. Computed tomography (CT) imaging confirmed acute uncomplicated appendicitis with a suspected foreign body. Further history revealed the recent consumption of Barramundi fish. The patient underwent laparoscopic appendectomy, which identified a fishbone perforating the appendiceal wall. The procedure was successfully completed without complications, and the patient had an uneventful recovery with discharge the following day. This case highlights the importance of considering foreign body ingestion as a potential cause of appendicitis, particularly in patients with relevant dietary history. Prompt diagnosis and surgical intervention are crucial in managing such cases effectively.

Keywords: acute appendicitis diagnosis; atypical appendicitis; fishbone perforation; foreign bodies; laparascopic surgery.

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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. Axial contrast-enhanced CT scan of the abdomen revealed a dilated appendix with wall thickening indicative of acute appendicitis, along with a 2 cm linear hyperdense structure (white arrow).
Figure 2
Figure 2. Laparoscopic image of a foreign body, namely, the fishbone (black arrow), which induced perforated appendicitis.
Figure 3
Figure 3. Photograph of the surgical specimen showed appendicitis due to a fishbone.
See this image and copyright information in PMC

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