内視鏡下の異物摘出で治癒した魚骨による胃穿孔の1例

  • 安藤 公隆
    岐阜大学医学部附属病院高次救命治療センター
  • 松橋 延壽
    岐阜大学医学部附属病院高次救命治療センター
  • 宮原 利行
    岐阜大学医学部附属病院高次救命治療センター
  • 山口 和也
    岐阜大学医学部腫瘍外科
  • 森 義雄
    岐阜大学医学部附属病院高次救命治療センター
  • 小倉 真治
    岐阜大学医学部附属病院高次救命治療センター

書誌事項

タイトル別名
  • A CASE OF SUCCESSFUL CONSERVATIVE THERAPY FOR GASTRIC PERFORATION BY AN INGESTED FISH BONE

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A 68-year-old woman complaining of lower abdominal pain was admitted to the hospital with a suspicion of peritonitis 12 hours after she ate a fish (yellowtail). Abdominal CT scan showed a linear high density structure in the prepyloric region of the stomach. Endoscopic examination revealed a fish bone stuck in the anterior wall of prepyloric region of the stomach. The fish bone, 3cm in length, was removed from the gastric wall endoscopically. From those studies, she was diagnosed as having localized peritonitis due to gastric perforation by the ingested fish bone and conservative therapy with antibiotics was started. The clinical course was satisfactory and uncomplicated. Abdominal CT taken 8 days after admission showed neither abnormal air collection nor abscess in the abdominal cavity. She was transferred to the department of internal medicine from our department on the 10th hospital day. In a review of the literature, 23 cases of gastric perforation by an ingested fish bone, including our case, have been reported, and among of then, successful conservative therapy has been done in few cases. Although gastric perforation by an ingested fish bone had been treated by surgery, endoscopical removal of the fish bone and conservative therapy with antibiotics may become the first choice of therapy for the disease.

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