Migration of fish bones into abdominal para‐aortic tissue from the duodenum after leading to duodenal perforation: a case report

Abstract Background Migration of fish bones into abdominal para-aortic tissue after penetrating the junction of 3rd and 4th part of duodenum is incredibly rare. Case presentation A 68-year-old man was admitted to our hospital with persistent colic in the lower abdomen after eating fish two weeks ago. Abdominal computed tomography (CT) scan showed High density streaks along the anterior and lower edges of the 3rd part of duodenum with peripheral exudation and localized peritonitis. Esophagogastroduodenoscopy didn’t find foreign bodies and perforations in the digestive tract. Laparoscopic surgery and intraoperative endoscopy were made to detect foreign bodies and perforation site was found. After transition to open surgery, the fish bone was found in abdominal para-aortic tissue and removed without complications. Postoperative recovery is smooth, and the patient resumed normal diet and was discharged. Conclusions It is difficult to choose a treatment plan for foreign bodies at the 3rd part of the duodenum, because it is difficult to judge the damage caused by the foreign body to the intestine and the positional relationship with the surrounding important organs. Conservative treatment or surgical treatment both have huge risks. The handling of this situation will extremely test the psychology, physical strength and professional experience of the surgeon.

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Case report of abdominal left upper quadrant collection secondary to fish bone perforation

Medicine and Pharmacy Reports ◽

10.15386/mpr-1429 ◽

2020 ◽

Author(s):

Marcel Ioan Gheorghiu ◽

Marion Bolliet ◽

Patrice David ◽

Bernard Denis

Keyword(s):

Case Report ◽

Unusual Case ◽

Foreign Bodies ◽

Fish Bone ◽

Small Fish ◽

Case Presentation ◽

Fish Bones ◽

Clinical Presentations ◽

Site Localization ◽

Inflammatory Syndrome

We present an unusual case of an intra-abdominal collection which evidenced a rare etiology and raises diagnostic particularities. Background. Fish bones ingestion is frequent, but seldom followed by complications. Those are often reported at specific sites. Objectives. This case report emphasizes the unusual presentation and site localization of a colonic perforation by a small fish bone, in the context of limited radiological accuracy at the diagnostic phase. Case presentation. A 37 year old male was admitted to the gastroenterology ward with upper and left sided abdominal pain associated with fever and marked fatigue. His medical history was marked by a sleeve gastrectomy in 2010 for obesity. Abdominal signs and elevated acute inflammatory syndrome on blood tests were followed by computer tomography which revealed a pericolic mass near the left splenic flexure. The pain and fever increased in intensity, so a laparotomy was proposed. Intraoperatively, a tumor-like lesion was found and a resection with oncologic limits was performed. Microscopic examination of the specimen revealed a fish bone, but only after surgery did the patient confirm that he had eaten fish meal the week before. The post-operative period was uneventful. Conclusion. Fish bones remain some of the most frequently ingested alimentary foreign bodies; they may cause atypical clinical presentations, frequently omitted by the patients themselves if symptoms appear delayed. They could also lead to possible high-risk complications which need to be addressed by surgeons.

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Migratory Fish Bone in the Thyroid Gland: Case Report and Literature Review

Case Reports in Medicine ◽

10.1155/2018/7345723 ◽

2018 ◽

Vol 2018 ◽

pp. 1-5 ◽

Cited By ~ 8

Author(s):

EnHao Wu ◽

Lei Huang ◽

Ya Zhou ◽

Xun Zhu

Keyword(s):

Foreign Body ◽

Thyroid Gland ◽

Foreign Bodies ◽

Relevant Literature ◽

Fish Bone ◽

Migratory Fish ◽

Emergency Case ◽

Presenting Symptoms ◽

Fish Bones ◽

The Common

Introduction. Foreign body stuck in the throat is a common emergency case, which can be removed by the endoscopic treatment. Fish bones are one of the common observed foreign bodies in the pharynx or cervical esophagus. Fish bones have a risk of damaging the mucosa when lodged in the upper digestive tract. Foreign bodies of fish bones located outside the laryngopharyngeal tissue are relatively unusual, and it is even more rare that they remain in the thyroid. It may cause local infection, abscess formation, large blood vessels rupture, and other serious life-threatening complications when the position of the fish bone migrates to the neck. We present a unique case of a 31-year-old woman in whom a fish bone was found in the thyroid. The fish bone had been removed successfully two months after the onset of symptoms. The relevant literature is reviewed and summarized.Case Presentation. A foreign body which is located in the neck area by swallowing is usually found in the emergency case. One of the commonest foreign bodies is the fish bone. The common presenting symptoms include foreign body (FB) sensation and or a sharp pain during swallowing. But we report a rare case in which a migratory fish bone stuck in the thyroid gland was found after 3 months. We retrieved previous literature and made a summary.Conclusions. Fish bones are not easy to be found as a foreign body. Surgeons should be aware that fish bones can become lodged in the thyroid gland. Combined with the history should be a wary fish bone to migrate to the case of the thyroid, to avoid misdiagnosis. To confirm the diagnosis, we can take ultrasound, computerized tomographic scanning (CT), and other tests.

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Metal Foreign Bodies Have Been in the Lungs for Five Years: a Case Report

10.21203/rs.3.rs-554998/v1 ◽

2021 ◽

Author(s):

Yuan Li ◽

Zhong Li ◽

Jun-Cai Liu

Keyword(s):

Foreign Body ◽

Pulmonary Artery ◽

Foreign Bodies ◽

Treatment Plan ◽

High Density ◽

Surgical Removal ◽

Metallic Foreign Body ◽

Case Presentation ◽

Appropriate Treatment ◽

Limb Trauma

Abstract Background: Metallic foreign body migration into the pulmonary artery after limb trauma is extremely rare. If not treated in time, the patient may die. The metallic foreign body was implanted from the thigh into the pulmonary artery and remained for 5 years. It has never been reported in limb trauma.Case Presentation: The patient was a 51-year-old male who had a small metal foreign body embedded in the middle and lower left thigh due to trauma. The foreign body was not found during emergency debridement operation. During the operation, a full-body X-ray was used to reveal a high-density shadow in the left upper lung. The 3D-CT of the chest immediately confirmed that the high-density shadow was a small iron foreign body, and the iron fragment foreign body was present in the pulmonary artery branch, but no abnormal symptoms were observed. He was hospitalized for observation for 3 days without obvious discomfort and refused to open his chest. The patient then decided to leave the hospital voluntarily.Conclusion: Surgical removal of all foreign bodies traveling to the pulmonary artery is not necessary, and the most appropriate treatment plan should be made considering the location of the foreign body, the patient's wishes and the general condition.

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Obstructive Pneumonia With Bronchial Foreign Body: A Case Report

10.21203/rs.3.rs-331826/v1 ◽

2021 ◽

Author(s):

Hitomi Tanaka ◽

Takatoshi Anno ◽

Haruka Takenouchi ◽

Hideaki Kaneto ◽

Toru Oga ◽

...

Keyword(s):

Foreign Body ◽

Foreign Bodies ◽

Laboratory Data ◽

Vital Signs ◽

Fish Bone ◽

Case Presentation ◽

Bronchial Foreign Body ◽

Old Japanese ◽

History Of ◽

Normal Chest

Abstract Background: Bronchial foreign bodies are relatively uncommon in adults. There are a variety of symptoms induced by airway foreign bodies, although the typical symptoms of some bronchial foreign bodies are cough, wheezing, chest pain, hemoptysis and fever up. Case presentation: An 80-year-old Japanese man was referred to our hospital with symptom of 7-month history of cough and pneumonia. His chest radiograph showed a slight increase in opacity. His vital signs and his laboratory data were almost normal. Chest computed tomography revealed obstructive pneumonia and a bronchial foreign body. We performed bronchoscopy and detected a fish bone as an intrabronchial foreign body and finally removed it from the bronchi.Conclusions:It is very important to carefully perform medical consultation about the current and past medical history. People in some countries and regions such as Japan have a habit of eating fish. It is necessary to more carefully consider the possibility of some bronchial foreign body such as a fish bone, when we observe symptoms of persistent cough.

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STOMACH FISH BONE PERFORATION.CLINICAL CASE

Modern medical technologies ◽

10.34287/mmt.3(46).2020.11 ◽

2020 ◽

Vol 46 (3) ◽

pp. 64

Author(s):

N.V. Rudik ◽

A. S. Sementsov ◽

D. B. Fedchuk

Keyword(s):

Computed Tomography ◽

Foreign Body ◽

Foreign Bodies ◽

Clinical Observation ◽

Fish Bone ◽

Specific Location ◽

Fish Bones ◽

Life Threatening ◽

Wall Perforation ◽

Tomography Data

Abstract Stomach foreign bodies take second place after foreign bodies of the esophagus and can be both harmless as well as life-threatening. The shape, size, and time of the swallowed foreign body to get deposited in the specific location determine the type of treatment. The article presents a clinical observation – the stomach wall perforation of fish bones, principles of examination of the patient, computed tomography data and surgical treatment. Keywords: stomach, foreign body, perforation, computed tomography, treatment.

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Migrated pharyngeal fish bone causing spondylodiscitis. Case report

Coluna/Columna ◽

10.1590/s1808-185120141301rcc69 ◽

2014 ◽

Vol 13 (1) ◽

pp. 67-68 ◽

Cited By ~ 1

Author(s):

Aluizio Augusto Arantes Júnior ◽

Jose Augusto Malheiros ◽

Marco Tulio Domingos Silva e Reis ◽

Gustavo Meyer de Moraes

Keyword(s):

Case Report ◽

Cervical Spine ◽

Foreign Body ◽

Foreign Bodies ◽

Fish Bone ◽

Emergency Rooms ◽

Infectious Process ◽

Fish Bones ◽

First Case ◽

Longus Colli

Ingestion of foreign bodies is a common problem seen at emergency rooms and frequently involves chicken and fish bones. There are few cases of migrated foreign bodies through the retropharynx causing infectious process in the area but no one, despite the proximity, causing spondylodiscitis. Perhaps such condition is attributed to the integrity of the longus colli fascia covering and protecting the cervical spine. We described the first case of spondylodiscitis due to a foreign body (saw-toothed fish bone) that penetrated the longus colli fascia and carved into vertebral body C3.

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Ingested Fish Bone: An Unusual Mechanism of Duodenal Perforation and Pancreatic Trauma

Case Reports in Gastrointestinal Medicine ◽

10.1155/2012/308510 ◽

2012 ◽

Vol 2012 ◽

pp. 1-3 ◽

Cited By ~ 1

Author(s):

Dimitrios Symeonidis ◽

Georgios Koukoulis ◽

Ioannis Baloyiannis ◽

Apostolos Rizos ◽

Ioannis Mamaloudis ◽

...

Keyword(s):

Foreign Body ◽

Epigastric Pain ◽

Elevated Serum ◽

Delayed Diagnosis ◽

Pancreatic Head ◽

Fish Bone ◽

Postoperative Recovery ◽

Intestinal Lumen ◽

Duodenal Wall ◽

Duodenal Perforation

Ingestion of gastrointestinal foreign bodies represents a challenging clinical scenario. Increased morbidity is the price for the delayed diagnosis of complications and timely treatment. We present a case of 57-year-old female patient which was admitted in the emergency room department complaining of a mid-epigastric pain over the last twenty-four hours. Based on the patient's history, physical examination and elevated serum amylase levels, a false diagnosis of pancreatitis, was initially adopted. However, a CT scan confirmed the presence of a radiopaque foreign body in the pancreatic head and the presence of air bubbles outside the intestinal lumen. The patient was unaware of the ingestion of the foreign body. At laparotomy, after an oblique duodenotomy, a fish bone pinned in the pancreatic head after the penetration of the medial aspect of the second portion of the duodenal wall was identified and successfully removed. The patient had an uneventful postoperative recovery. Wide variation in clinical presentation characterizes the complicated fish bone ingestions. The strategically located site of penetration in the visceral wall is responsible for the often extraordinary gastrointestinal tract injury patterns. Increased level of suspicion is of paramount importance for the timely diagnosis and treatment.

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Aorto-esophageal fistula caused by fishbone ingestion: a case report on staged endovascular and endoscopic treatment

BMC Gastroenterology ◽

10.1186/s12876-021-01624-9 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Yu-Yan Zhang ◽

Shan Li ◽

Xiang-Lei Yuan ◽

Bing Hu

Keyword(s):

Foreign Bodies ◽

Normal Diet ◽

Thoracic Endovascular Aortic Repair ◽

Esophageal Fistula ◽

Fistula Repair ◽

Active Infection ◽

Case Presentation ◽

Endoscopic Closure ◽

Esophageal Lesion ◽

Laboratory Examinations

Abstract Background Aorto-esophageal fistula (AEF) caused by foreign bodies ingestion is a rare but devastating disorder. Thoracic endovascular aortic repair (TEVAR) has become a widely accepted intervention for treating aorto-esophageal fistulas. As for post-TEVAR esophageal defect, secondary esophagectomy has been the recommended choice for most of the AEFs, but there is no general consensus with regard to the need of secondary surgeries for patients in the absence of clear signs of reinfection or bleeding. We herein presented a case of an AEF caused by fishbone ingestion, after successful TEVAR, the esophageal lesion was closed endoscopically. Case presentation A 38-year-old male presented with esophageal fistula for 4 months. He was diagnosed with AEF because of Chiari's triad after fishbone ingestion 4 months ago. Emergency thoracic aortic stent implantation was done, and given broad spectrum antibiotics and blood transfusion. His symptoms were improved, and discharged with an esophageal fistula left to heal itself. Nevertheless, after 4 months, re-examination of esophago-gastro-duodenoscopy revealed that the diameter of the fistula was changed from 3 to 6 mm. He was then admitted to our hospital for esophageal fistula repair. Laboratory examinations and chest computed tomography showed no signs of active infection, and endoscopic closure of the fistula was achieved with 4 clips. After that, he was discharged and gradually returned to normal diet. Conclusion For AEFs in the absence of active infection with repaired aorta but persistent esophageal fistula, endoscopic closure by endoclips might be an effective treatment choice.

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A Rare Case of a Foreign Body Migration from the Upper Digestive Tract to the Subcutaneous Neck

Ear Nose & Throat Journal ◽

10.1177/014556130208101014 ◽

2002 ◽

Vol 81 (10) ◽

pp. 730-732 ◽

Cited By ~ 12

Author(s):

Kenny Peter Pang ◽

Yoke Teen Pang

Keyword(s):

Foreign Body ◽

Digestive Tract ◽

Rare Case ◽

Foreign Bodies ◽

Soft Tissues ◽

Fish Bone ◽

Fish Bones ◽

Upper Digestive Tract ◽

Foreign Body Migration ◽

Base Of The Tongue

Ingested foreign bodies are not unusual in Singapore. The most common of these objects are fish bones, which typically become lodged in the tonsils or in the base of the tongue. We report a rare case of an ingested fish bone that migrated from the upper digestive tract and into the soft tissues of the neck just below the skin.

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Characteristics of fish-bone foreign bodies in the upper aero-digestive tract: The importance of identifying the species of fish

PLoS ONE ◽

10.1371/journal.pone.0255947 ◽

2021 ◽

Vol 16 (8) ◽

pp. e0255947

Author(s):

Tadahisa Shishido ◽

Jun Suzuki ◽

Ryoukichi Ikeda ◽

Yuta Kobayashi ◽

Yukio Katori

Keyword(s):

Foreign Body ◽

Digestive Tract ◽

Fish Species ◽

Foreign Bodies ◽

Age Distribution ◽

Fish Bone ◽

University Hospital ◽

Surgical Removal ◽

Endoscopic Removal ◽

Fish Bones

Background Fish bones are common foreign bodies in the upper aero-digestive tract, but their clinical features in relation to fish species have not been confirmed. We aimed to clarify the clinical characteristics of fish-bone foreign bodies and their location and removal methods depending on the fish species. Study design Retrospective, observational, monocentric study. Methods From October 2015 to May 2020, 368 patients visited the Department of Otolaryngology-Head and Neck Surgery at Tohoku University Hospital complaining of dysphagia, sore throat, or pharyngeal discomfort after eating fish. We analyzed the patients’ sex and age distribution, foreign-body location, type of the fish, and the techniques used for removing the foreign body. Results Fish bones were confirmed in the upper aero-digestive tract in 270 cases (73.4%), of which 236 (87.4%) involved fish-bone foreign bodies in the mesopharynx. The most frequently involved site was the palatine tonsil (n = 170). Eel was the most frequently observed fish species (n = 39), followed by mackerel (n = 33), salmon (n = 33), horse mackerel (n = 30), and flounder (n = 30). Among the 240 cases in which the bones did not spontaneously dislocate, 109 (45.4%) were treated by endoscopic removal (103 cases) or surgery (6 cases). In pediatric cases (<12 years old), almost all fish bones were found in the mesopharynx (138/139, 99.3%), and 31 cases (22.3%) required endoscopic removal. Flounder fish bones were often lodged in the hypopharynx and esophagus (9/30, 30%), hindering spontaneous dislocation and frequently necessitating endoscopic or surgical removal (19/29, 65.5%). Conclusion The characteristics of fish-bone foreign bodies differed depending on the fish species. Flounder bones were often stuck in the hypopharynx and esophagus and were likely to require more invasive removal methods. Confirming the species of the fish could facilitate appropriate diagnosis and treatment of fish-bone foreign bodies.

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