Kosin Med J.  2018 Dec;33(3):415-421. 10.7180/kmj.2018.33.3.415.

A case of intra-abdominal abscess caused by unconsciously ingestion of fish bone in elderly patient

• Kim BR
• Kim HJ
• Hahm JR
• Ha CY
• Jung WT
• Lee OJ

• KMID: 2442554
• DOI: http://doi.org/10.7180/kmj.2018.33.3.415

Abstract

Cases showing complications such as esophageal injury, deep neck infection, and mediastinitis caused by accidental ingestion of fish bone are common. But ingestion of fish bone rarely causes perforation of the gastrointestinal tract or an intra-abdominal abscess. We report herein a case of a 78-year-old man with a periumbilical mesenteric abscess caused by fish bone which was ingested unconsciously. The fish bone was found in the terminal ileum and it was removed by colonoscopy. The patient improved and he was discharged after systemic antibiotic therapy. Occasionally, when patients swallow fish bone without a foreign body sensation, clinicians should suspect perforation caused by fish bone in case of an intra-abdominal abscess of unknown cause.

Keyword

Colonoscopy; Elderly patient; Fish bone; Mesenteric abscess

MeSH Terms

Abdominal Abscess*
Abscess
Aged*
Colonoscopy
Eating*
Foreign Bodies
Gastrointestinal Tract
Humans
Ileum
Mediastinitis
Neck
Sensation

Figure

• 

  Fig. 1 Initial abdominal computed tomographic scan revealed an approximately 5cm cystic lesion with contrast enhancement of the wall associated with adjacent fatty infiltration within the periumbilical mesentery.

• 

  Fig. 2 A sharp fish bone was observed in the terminal ileum and removed by forceps.

• 

  Fig. 3 The fish bone was 2 cm in length and sharp.

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  Fig. 4 The abscess was not visible in the follow up CT scan in 7 weeks.

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