Small bowel perforation by ingested fish bone

Case contributed by Nicolo Davide Colomba

Presentation

Patient presented to the emergency with acute abdomen and no significant leukocytosis.

Patient Data

Age: 75 years
Gender: Female

In a small bowel loop between the jejunum and ileum, a thin hyperdense hook-shaped object can be seen. The foreign body goes through the bowel wall and there is mild diffuse stranding of the adjacent fat with multiple reactive mesenteric lymph nodes. No pneumoperitoneum.

The remaining findings are unremarkable.

Intraoperative finding

Photo

Intraoperative image of the fish bone perforating the bowel wall (courtesy of Doctor Massimo Chiarot).

Case Discussion

In some regions, ingestion of fish bones is one of the most common cause of small bowel perforation.

The most sensitive exam in detecting foreign bodies in the bowel lumen is CT.

This patient had the fish bone removed by the surgeon and recovered without any other complications after two days of hospitalization.

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