Medical treatment for a fish bone-induced ileal micro-perforation: A case report

Fish bone perforation into a patent urachus mimicking urachal carcinoma: Case report

Ingestion of foreign body may induce complications such as perforation, impaction, or penetration. Diagnosis rarely made preoperatively due to clinical symptoms are usually nonspecific and can mimic other surgical conditions. A 69-year-old male presented to emergency department with vague abdominal pain for few days. Following a clinical evaluation and computed tomography scan of the abdomen, provisional diagnosis of urachal carcinoma was made. As the result of urachal excision with partial cystectomy including fishbone were resected, pathology revealed benign urothelium.

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

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.

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Foreign body swallowing is one of common complaints in hospitals.

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Most of the foreign bodies pass through the gastrointestinal tract (GIT)without any significant harm or complications.

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Diagnosis of perforation secondary to fish is rarely done preoperatively.

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Management of bowel perforation could be either surgical or non-surgical.

Development of an abdominal wall abscess caused by fish bone ingestion: a case report

Background

A small percentage of patients with foreign body ingestion develop complications, which have a variety of clinical presentations. Less than 1% of cases require surgical intervention. We present a patient with an abdominal wall abscess resulting from a fish bone that pierced the cecum. The patient was treated laparoscopically.

Case presentation

A 55-year-old Japanese man presented to our hospital with a complaint of right lower abdominal pain. A physical examination revealed tenderness, swelling, and redness at the right iliac fossa. Computed tomography showed a low-density area with rim enhancement in his right internal oblique muscle and a hyperdense 20 mm-long pointed object in the wall of the adjacent cecum. Based on the findings we suspected an abdominal wall abscess resulting from a migrating ingested fish bone. He was administered antibiotics as conservative treatment, and the abscess was not seen on subsequent computed tomography.

Two months after the initial treatment, he presented with the same symptoms, and a computed tomography scan showed the foreign body in the same location as before with the same low-density area. We diagnosed the low-density area as recurrence of the abdominal wall abscess. He underwent laparoscopic surgery to remove the foreign body. His appendix, and part of his cecum and the parietal peritoneum that included the foreign body, were resected. He had an uneventful postoperative course, and at 1 year after the surgery, the abdominal wall abscess had not recurred.

Conclusions

An abdominal wall abscess developed in association with the migration of an ingested fish bone. We suggest that a laparoscopic surgical resection of the portion of the bowel that includes the foreign body is a useful option for selected cases.

Colon perforation caused by swallowing a shrimp leg: A case report

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Colon perforation caused by swallowing a shrimp leg is the first reported case currently.

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Chronic perforation of colon may not need emergent surgery.

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Laparoscopic drainage and removal of shrimp leg is effect treatment to diminish hospital days.

Introduction

Ingestion of a foreign body rarely results in perforation of the gastrointestinal tract. Foreign bodies such as dentures, fish bones, chicken bones, toothpicks and cocktail sticks have been known to cause bowel perforation; however, bowel perforation caused by shrimp leg has not been reported so far.

Presentation of case

We report a case of a 69-years-old man who presented with a 4-months epigastric 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.

Discussion

An increased incidence of perforation has been reported in association with Meckel’s diverticulum, the appendix, and diverticular disease. The abdominal abscess in this case was located beside the diverticulum of transverse colon, so the perforation most likely occurred in the diverticulum of transverse colon.

Conclusion

Perforation of colon by shrimp leg is very rare and not reported currently. Although some cases have been successfully treated chronic foreign-body perforation with abscess by using antibiotics alone, typical treatments remains surgical drainage of the abscess and removal of foreign body.

Extra luminal migration of ingested fish bone to the spleen as an unusual cause of splenic rupture: Case report and literature review

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Foreign body ingestion is a relatively common and benign condition; some serious complications, however, can arise.

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Approximately 1% of all ingested FB will cause perforation requiring surgical treatment.

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Sharp FB, such as fish bones, chicken bones and needles, are more prone to migrate outside the gastrointestinal lumen if they are not removed early.

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The patient reported here is the first one in the literature to present a splenic rupture due to extra-luminal migration of an ingested fish bone through the splenic flexure of the colon.

Introduction

The ingestion of foreign bodies (FB) is a common problem worldwide and affects all ages; it is, however, particularly important in the pediatric population and in mentally impaired adults. The typical outcome of FB ingestion is good, since the majority of ingested material is passed spontaneously through the gastrointestinal tract. Serious complications can occur, however, including bowel perforation or obstruction and gastrointestinal bleeding, amongst others. Extraluminal migration of ingested foreign bodies is very rare and reported cases so far have shown, more commonly, migration to neck structures, with very few reported cases of migration to the abdomen. To date, there is no reported case of extraluminal migration of ingested FB to the spleen.

Case presentation

A 59-year-old man presented with acute abdominal pain and dyspnea. A CT scan revealed a FB within the spleen, with a ruptured capsule and perisplenic collection. Surgery was performed and a 3cm-long fishbone was extracted, with hemoperitoneum secondary to spleen rupture. The patient was discharged on the third postoperative day with good recovery and without any complications; pneumococcal polysaccharide vaccination was provided.

Conclusion

FB ingestion is a relatively benign condition; however, some serious complications can arise infrequently. The patient reported herein is the first in the literature to present a splenic rupture due to extra luminal migration of an ingested fish bone.

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.

Risk factors for esophageal complications of ingestion of fish bones in adults

AIM: To determine the risk factors associated with esophageal complications of ingestion of fish bones in adults.

METHODS: Seventy-five adult patients who had ingestion of fish bones were investigated at our hospital. The complications were analyzed and the risk factor for them were identified with regard to patient characteristics, fish bone characteristics and the relationship between fish bones and the esophageal wall. Binary Logistic regression was used to explore the associations between the potential risk factors (independent variables) and the complications (dependent variables).

RESULTS: Forty-six cases had complications associated with ingestion of fish bones, which included erosions (23, 30.26%), lacerations (10, 13.16%), ulcers (8, 10.53%), and perforation (5, 6.58%). Multivariate Logistic regression analysis showed that the esophageal wall being penetrated by fish bone, obvious symptoms, history of strong swallowing and duration of impaction ≥ 24 h were significant independent risk factors for complications (P < 0.05).

CONCLUSION: The risk for complications in patients with the esophageal wall being penetrated by fish bone or obvious symptoms is higher. In patients who have no history of strong swallowing or receive early diagnosis and treatment, the risk of complications is lower.