Hydronephrosis caused by intra-abdominal abscess from cecal perforation by an ingested fish bone

Ureteral obstruction and hydronephrosis caused by foreign body: A case report and literature review

RATIONALE

Foreign bodies related ureteral obstruction and hydronephrosis is rare and usually cause numerous problems for clinical physicians.

PATIENT CONCERNS

We report a 36-year-old female who was referred to our hospital due to a 4-year history of dull pain on the left back.

DIAGNOSIS

X-ray and abdominal CT revealed a foreign body around the upper part of the left ureter with ureteral obstruction and hydronephrosis.

INTERVENTIONS

Laparoscopy was performed and a 3-cm sewing needle was removed successfully.

OUTCOMES

After 6 months' follow-up, the patient's ureteral obstruction and hydronephrosis were significantly reduced, and the double-J ureteral stent was removed.

LESSONS

This case indicated that ureteral obstruction and hydronephrosis caused by foreign bodies needed to be early diagnosed and located. Invasive therapies rather than conservative treatments are preferred to remove the FBs and relieve obstruction.

Diagnostic dilemmas due to fish bone ingestion: Case report & literature review

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Pre-operative diagnosis of fish bone perforation of the bowel is difficult.

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It usually mimics common abdominal pathology.

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A low threshold must be maintained to perform a diagnostic laparoscopy.

Introduction

The diagnosis of abdominal complications due to fish bone ingestion is particularly difficult as the presentation may mimic common abdominal pathologies.

Presentation of case

65 year-old male presented with a two day history of right iliac fossa pain. He denied any nausea and vomiting. He had no systemic systems including fever, change in bowel habit. He had tenderness and guarding localized to the right iliac fossa. He had raised inflammatory markers. A CT scan of the abdomen was performed which showed fat standing in proximity to the terminal ileum, with the appearance of Crohn’s disease. The clinical picture did not match the imaging and so the patient underwent a diagnostic laparoscopy. Findings included an acutely inflamed terminal ileum. A foreign body was identified piercing through at the small bowel wall at the terminal ileum. The foreign body was removed and revealed a fish bone. Intracorporeal sutures were inserted at the site of the microperforation. The patient was discharged well two days post operatively.

Discussion

Fish bone perforation is not a common cause of gastrointestinal perforation. Unfortunately the history is often non-specific and these people can be misdiagnosed with acute appendicitis & other pathologies. CT scans can be useful to aid diagnostics. It is not however fully sensitive in detecting complications arising from fishbone ingestion.

Conclusion

Management therefore, should be based taking into account primarily the clinical picture & may necessitate diagnostic laparoscopy.

Successfully treated intra-abdominal abscess caused by fish bone with perforation of ascending colon: a case report

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.

Right-sided hydronephrosis secondary to swallowing a headscarf pin

A majority of foreign objects ingested pass through the gastrointestinal tract without any complications. Sometimes, complications such as perforation and adhesions of the neighboring organs occur and surgical treatment becomes necessary. We report the case of a 22-year-old female who was admitted with right flank pain. Past medical history revealed that the patient had accidentally swallowed a headscarf pin 11 months earlier. A computed tomography scan confirmed the swallowed foreign body posterior to and around the ileocecal region. The headscarf pin, causing stenosis and proximal ureteral dilatation, was removed surgically. To the authors' knowledge there has been no previous report of such ureteral obstruction published in the English literature.