Three Cases of Perforation or Penetration of Digestive Tract by Ingested Fish Bone

Toshiaki Ando, Masahiko Onda, Yukichi Moriyama, Noritake Tanaka, Shoji Kyono, Tadashi Kobayashi

First Department of Surgery, Nippon Medical School

The perforation or penetration of digestive tract due to ingested fish bone is relatively rare, and preoperative diagnosis is very difficult. Two cases of small intestinal perforation and a case of anal penetration by ingested fish bone are reported. Preoperatively, one of the two intestinal perforated cases was diagnosed by abdominal CT, and the anal penetration case was diagnosed by digital examination. In previous Japanese reports, in addition to our three cases, 240 cases of this disease have been reported. Perforation or penetration appeared, in the decresing order of prevalence, in the anus, ileum, transverse colon, sigmoid colon, and esophagus. Even though most patients wre surgically treated, a preoperative diagnosis was unusual. Especially, there were only seven cases, besides ours, of preoperative diagnosis of intraperitoneal perforation or penetration, and most of these were diagnosed by abdominal CT, as in our case. In preoperative diagnosis, CT may be particularly helpful in patients in whom the perforation or penetrtion of the digestive tract is causd by ingested fish bone. In the previous reports, all patients that were preoperatively diagnosed had chronic inflammatory lesions. Our case is the first report in Japan of preoperative diagnosis of panpertonits due to intestinal perforation caused by ingested fish bone.

Key words
peforation or penetration of digestive tract, ingested fish bone, CT scan

Reprint requests
Toshiaki Ando First Department of Surgery, Nippon Medical School
1-1-5 Sendagi, Bunkyou-ku, Tokyo, 113 JAPAN

Accepted
November 8, 1989

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