A CASE OF INTRA-ABDOMINAL ABSCESS DUE TO GASTROINTESTINAL PERFORATION OF A FISH BONE

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  • TAKEMURA Takao
    Department of Surgery, Kanagawa Prefectural Atsugi Hospital
  • DOI Naoki
    Department of Surgery, Kanagawa Prefectural Atsugi Hospital
  • SAITO Haruo
    Department of Surgery, Kanagawa Prefectural Atsugi Hospital
  • YOSHIDA Tsugunori
    Department of Surgery, Kanagawa Prefectural Atsugi Hospital
  • INOUE Koichi
    Department of Surgery, Kanagawa Prefectural Atsugi Hospital
  • KANAI Masaki
    Department of Surgery, Kanagawa Prefectural Atsugi Hospital

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Other Title
  • 魚骨の消化管穿孔による腹腔内膿瘍の1例

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Abstract

We experienced a case of intra-abdominal abscess due to gastrointestinal perforation of a fish bone.<br> A 54-year-old man was admitted to the hospital because of a left lower abdominal pain and fever. On admission abdominal ultrasonography and abdominal CT revealed an intra-abdominal abscess in the left lower abdomen. Abdominal CT visualized a lineal high density foreign body in the abscess. A diagnosis of gastrointestinal perforation of a fish bone was made. After a decrease in size of the abscess and symptomatic remission were confirmed, the patient was discharged from the hospital. CT after discharge visualized that the tumor almost disappeared, but the foreign body did not disappear. Operation was carried out. Operative procedures included partial excision of the omentum and seromuscular sutute of the ileum where appeared to be a perforated site. An about 1.5cm fish bone was removed from the omentum. Postoperative course was uneventful and the patient was discharged on the 10th postoperative day.<br> Gastrointestinal perforation due to a fish bone is a relatively rare entity. It has been believed that making a preoperative diagnosis is difficult, but with a recent progression in imagings such as CT the disease has come to be easily diagnosed preoperatively. In this case we successfully performed a less invasive surgical treatment with elective operation.

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