A case of perforation of the jejunum in which an ingested fish bone passed into an intraperitoneal abscess cavity was detected

• Published in: Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) Vol. 72; no. 5; pp. 1137 - 1140
• Main Authors: SAKAI, Mamoru, MORIYAMA, Toru, SHIMIZU, Kaori, MATSUURA, Hiroshi, FUJITA, Toru
• Format: Journal Article
• Language: Japanese
• Published: Japan Surgical Association 2011
• Subjects: fish bone; intraperitoneal abscess; perforation of jejunum
• ISSN: 1345-2843; 1882-5133
• DOI: 10.3919/jjsa.72.1137

A 90-year-old woman was referred to the hospital because of the abrupt onset of upper abdominal pain occurred about 2 weeks after she ate a slice of salmon, so-called “harasu (fish meat over the viscus)”. An abdominal CT scan showed abscess formation in the upper abdomen, and an about 2 cm-long high density linear shadow was identified within the abscess. Intraperitoneal abscess due to a fish bone was diagnosed and the patient was urgently admitted for observation of her clinical course. On the next day, peritonitis was exacervated and emergency operation was performed. Laparotomy disclosed an abscess at an area surrounded by the proximal jejunum, its small bowel mesentery, and the greater omentum, and a fish bone which had passed into the abscess. However, no perforated site was detected at the jejunal wall and only abscess drainage was performed. The postoperative course was uneventful. She was discharged from the hospital on the 15th postoperative day. We present this case of perforation of the jejunum due to an ingested fish bone which was cured by drainage without any invasive surgical therapies, because no perforated site was identified during surgery though the fish bone was found in the intraperitoneal abscess. Some bibliographical comments are presented as well.