Intestinal Perforation by Fish Bone: Case Report and Review of 271 Cases in the Japanese Literature

Kikuo Yoh, So Inoue, Yasuo Watanabe and Hajime Yonekawa

Department of Surgery, Keio University Ise Keio Hospital

A 57-year-old man hospitalized with lower abdominal pain was found to have panperitonitis diagnosed through tenderness, rebound tenderness, and muscular defense in the lower abdomen. Abdominal plain film showed a 3-cm linear shadow corresponding to the site of tenderness and abdominal computed tomography showed a 2-cm linear shadow in the intestine. We thus diagnosed an intestinal perforation due to a fishbone and undertook emergency surgery. Fish bone perforation of the ileum was diagnosed preoperatively. We review 271 cases of intestinal perforation by fish bones repirted in the Japanese literature since 1990. Many perforation sites were observed, including the ileum,the transverse colon and the sigmoid colon with the mesenterium and not fixed to the retroperitoneum. Surgery was performed in 229 cases, from which 51 cases were diagnosed preoperatively.

Key words
intestinal perforation, fish bone, gastrointestinal foreign body

Reprint requests
Kikuo Yoh Department of Emergency medicine, Keio University School of Medicine 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582 JAPAN

Accepted
July 30, 2001

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