A case of gastric perforation by a fish bone preoperatively diagnosed with computed tomography

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  • CTにて術前診断した魚骨による胃穿孔の1例
  • 症例 CTにて術前診断した魚骨による胃穿孔の1例
  • ショウレイ CT ニテ ジュツゼン シンダン シタ ギョコツ ニ ヨル イ センコウ ノ 1レイ

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Abstract

A 62-year-old woman was admitted to the hospital because of upper abdominal pain and high fever. An abdominal X-ray film showed no demonstrable free air. An abdominal CT scan showed an about 3-cm long linear high density foreign object, which had penetrated the anterior wall of the gastric antrum, and free air around it. Perforation of the stomach by a fish bone was likely, and emergency surgery was carried out. Laparotomy disclosed a funicular foreign object to have penetrated the anterior wall of the gastric antrum. The object was removed and the perforation site was filled with the lesser omentum. The foreign object was a hollow funicular material about 3.5 cm in length. It was considered to be a fish bone based on the patient interview and its macroscopic findings.<BR>We also made an analysis of a total of 446 cases of perforation or penetration of the digestive organs due to a fish bone reported in the Japanese literature during 10 years from 2001 to 2010. Cases of perforation of the stomach by a fish bone were few, accounting for 7.8% (35 cases) of all cases. The correct diagnosing rate before surgery is recently increasing with a preoperative use of CT. In this paper, we present a relatively rare case of perforation of the stomach by a fish bone, together with a review of the Japanese literature.

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