Abstract
We report a case of a pyogenous vesical abscess resulting from an ingested fish bone embedded in the bladder wall that was treated endoscopically in an asymptomatic man. Computed tomography of the abdomen showed a linear radiopaque structure in the thickened left anterolateral wall of the bladder. Cystoscopy revealed a protruding mass, covered with normal-appearing mucosa, with outflow of pus from a shallow recess. Histopathological findings indicated that the transurethrally removed linear structure, located in the submucosa, was compatible with fish bone. A high index of suspicion should be maintained for the correct diagnosis to be made.
Highlights
Foreign body (FB) ingestion is not an uncommon problem encountered in clinical practice
Most ingested FBs pass through the gastrointestinal (GI) tract uneventfully within one week, and GI perforation is rare, occurring in less than 1% of patients [1]
FB perforation occurs in all segments of the GI tract it tends to occur in regions of acute angulation such as the ileocecal and rectosigmoid junctions [2]
Summary
Foreign body (FB) ingestion is not an uncommon problem encountered in clinical practice. Fish bones are the most commonly ingested objects and a common cause of FB perforation of the GI tract [3]. The development of abscess formation after the migration of a fish bone into an adjacent organ such as the bladder is extremely rare. We describe the first case of a pyogenous vesical abscess resulting from a fish bone embedded in the submucosa of the bladder treated transurethrally. The patient had no apparent abdominal and voiding symptoms He was afebrile, and physical examination findings were almost normal. CT of the abdomen demonstrated that a linear radiopaque structure, measuring 26 mm in length, traversed the thickened left anterolateral wall of the bladder (Figure 1). The patient gave a history of ingesting a fish bone accidentally. Clinical history and CT findings strongly suggested an abscess of the bladder wall secondary to migration of a fish bone. Transurethral biopsy of the bladder prior to partial cystectomy was performed because malignancy
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