Fish bone perforation mimicking colon cancer: A case report.

Thokozani Sibanda,Anne Ndlovu,Pria Pakkiri

doi:10.4102/sajr.v24i1.1885

Abstract

Most patients who ingest fish bones do not develop any complications. The small proportion of patients who do complicate, present with non-specific symptoms. A 64-year-old female patient presented with a 2-month history of abdominal pain. Following clinical evaluation and computed tomography scan of the abdomen, a provisional diagnosis of colon cancer was made. Histology of the resected bowel at hemicolectomy demonstrated a perforation by fish bone with an associated abscess. The case illustrates how fish bone perforation may mislead unsuspecting clinicians and may be misdiagnosed as colonic cancer.

Highlights

Fish bone ingestion is a common problem, in populations who consume unfilleted fish.[1]
Accidentally ingested fish bones are eliminated from the gastrointestinal tract (GIT) without complications.[2]
We present a patient whose symptoms and clinical findings were commensurate with perforated colon cancer

Summary

Introduction

Fish bone ingestion is a common problem, in populations who consume unfilleted fish.[1]. Bowel perforation is one of the serious complications, resulting mainly from the sharp or pointed edges of the fish bone.[3] the incidence is less than 1%.4. We present a patient whose symptoms and clinical findings were commensurate with perforated colon cancer. A definitive diagnosis of fish bone perforation was made after hemicolectomy and histopathology analysis. A 64-year-old female patient presented to her general practitioner with a 2-month history of left upper quadrant pain. No change in bowel habit was documented On examination, she was a well-looking lady with mild left upper quadrant tenderness. After review of the history and examination, the general surgeon’s differentials were diverticulosis, inflammatory bowel disease and colon cancer. A small opening was identified in the bowel wall and further sectioning revealed a fish bone (Figures 4 and 5)

Discussion

Conclusion

Findings

Data availability statement