Fish Bone Ingestion Research Articles

Laparoscopic removal of an ingested fish bone that penetrated the stomach and was embedded in the pancreas: a case report

BackgroundThe gastrointestinal tract can occasionally be perforated or penetrated by an ingested foreign body, such as a fish bone. However, there are very few reported cases in which an ingested fish bone penetrated the gastrointestinal tract and was embedded in the pancreas.Case presentationAn 80-year-old male presented with epigastric pain. Computed tomography of the abdomen showed a linear, hyperdense, foreign body that penetrated through the posterior wall of the gastric antrum. There was no evidence of free air, abscess formation, migration of the foreign body into the pancreas, or pancreatitis. As the patient had a history of fish bone ingestion, we made a diagnosis of localized peritonitis caused by fish bone penetration of the posterior wall of the gastric antrum. We first attempted to remove the foreign body endoscopically, but failed because it was not detected. Hence, an emergency laparoscopic surgery was performed. A linear, hard, foreign body penetrated through the posterior wall of the gastric antrum and was embedded in the pancreas. The foreign body was safely removed laparoscopically and was identified as a 2.5-cm-long fish bone. Intraperitoneal lavage was performed, and a drain was placed in the lesser sac. The patient recovered without complications and was discharged on the 7th postoperative day.ConclusionLaparoscopic surgery could be performed safely for the removal of an ingested fish bone embedded in the pancreas.

Gastric perforation due to fish bone ingestion presenting as gastric outlet obstruction: a case report

Foreign body ingestion is mostly an accidental incident and usually seen in children than in adults. In adults fish bone ingestion is a common occurrence which is generally asymptomatic and passes through gut without any complications. Ingestion of fish bone leading to gut perforations has been reported and includes distal part of the gastrointestinal tract involving ileum, colon and rectum. Gastric perforation is quiet rare due to its thick muscular wall. Here we present a case of a 65 year old female who presented to our hospital with complains of pain abdomen, vomiting and epigastric lump. On thorough investigation a perforation in the posterior wall of stomach was found along with a fish bone inside an inflammatory lump near the pylorus in the lesser sac, with features of gastric outlet obstruction. Initial conservative management resolved the inflammatory lump and then diagnostic laparoscopy followed by open surgery was performed to retrieve the fish bone. Both open and laparoscopic methods have been successful in retrieving these foreign bodies. Careful investigations and high level of suspicion is required for proper diagnosis and treatment for this benign condition.

Pyogenic Liver Abscess Secondary to Bowel Perforation by Ingested Fish Bone

Accidental ingestion of foreign bodies is a common clinical occurrence in medical practice, but hepatic abscess caused by said ingested foreign bodies is rather uncommon. Pre-operative diagnosis is difficult due to lack of patient awareness of the foreign body as well as non-specific symptoms and imaging findings. We hereby report a rare case of a 68-year-old African male who was admitted with fever and abdominal pain. Further investigation revealed a pyogenic liver abscess caused by an ingested fish bone penetrating the second part of the duodenum, without resolution despite initial antibiotic therapy. Final diagnosis and treatment included a combined endoscopic and surgical approach to remove the fish bone and repair the duodenal perforation along with CT-guided drainage of the abscess by interventional radiology.

Endoscopic Removal of Gastric Perforating Fish Bone

Introduction: A foreign body ingestion in adults is usually diagnosed by medical history. In most cases, the foreign body passes through the gastrointestinal tract uneventfully. Complications such as perforation are rare and usually occur in areas of angulation or narrowing such as the gastric antrum. We present a case of an unintentional perforating fish bone ingestion that was found incidentally on cross-sectional imaging and was managed endoscopically. Case description: A 51-year-old woman presented to the hospital for subacute upper abdominal pain. The patient described the pain as crampy, accompanied by waxing-waning nausea and dry heaves. She had melena 2 weeks prior, for which she underwent a colonoscopy and an EGD which revealed polyps that were removed endoscopically. Her prior surgical history included open nephrectomy for a right kidney swelling. On examination, the patient was afebrile, hemodynamically stable and in no apparent distress. Her abdomen was soft, non-distended with mild epigastric tenderness, and no guarding or rebound tenderness. Lab tests revealed a white cell count of 12,600/mm3 and hemoglobin of 13.1 g/dl. A CT scan of the abdomen revealed a 3.2 cm intramural curvilinear foreign body within the gastric antrum, with an associated thickened antrum and pylorus and no evidence of extra-luminal air or bowel obstruction. After further questioning, the patient reported having eaten fish 3 weeks ago and had a fish bone stuck in her throat, which she was able to cough out. An urgent upper endoscopy was performed - revealing a large fish bone perforating through the gastric incisura. An overtube was placed and the fish bone was removed using a rat tooth forceps. The defect was closed with an over-the-scope clip. The patient post-endoscopy course was uneventful and she was discharged home. Discussion: Since foreign body ingestion is usually uneventful, conservative treatment is warranted in the majority of cases. Complications are more likely with foreign bodies that are sharp such as fish bones. CT is the most sensitive in locating the causal fish bone, most often appearing as a high-density linear structure within inflamed tissue. In our case, the foreign body finding on abdominal CT and the history of ingested fish bone, raised a high index of suspicion for a perforating fish bone, indicating urgent endoscopic intervention. Fish bone migrating into solid organs or intraperitoneal areas would require surgical intervention.1865_A Figure 1. Abdominal CT1865_B Figure 2. No Caption available.1865_C Figure 3. Endoscopic clip

Cricoid ridge ossification mimicking ingested fish bone on plain radiography: prevalence in Singapore.

Ossification of the cricoid ridge mimicking impacted upper aerodigestive tract fish bone has been described in several case reports. We performed this study to determine the prevalence of such ossification in an adult population from Singapore and to identify specific imaging features that may aid in differentiating patients with cricoid ridge ossification from those with an upper aerodigestive tract impacted fish bone. We retrospectively evaluated 442 lateral neck radiographs of patients aged 16 years and above that were taken at the adult emergency department at National University Hospital, Singapore, during the four-month period between 1 September 2014 and 31 December 2014. Ossification of the cricoid ridge mimicking fish bone appeared in 3.2% of our adult patients and was more common among patients aged above 40 years (n = 11/227; 4.8%). The ossified cricoid ridge was usually located at the C6 level (n = 9) and had a mean length of 5.5 (range 2-9) mm. Ossified cricoid ridges may be misinterpreted on lateral neck radiography as ingested fish bones. While ossification of the cricoid ridge mimicking fish bones is rare, awareness of such ossification would reduce unnecessary further investigations of the upper aerodigestive tract in patients suspected of having an impacted foreign body.

Common Carotid–Esophageal Fistula following Migrated Fish Bone: A Rare Case report

Introduction . Accidental ingested fish bone is a quite common clinical problem in emergency department, especially in Asian countries where un–filleted fish is a delicacy. Normally, the fish bone will be passing by through GI tract. Less frequently it may have penetrated to esophagus lead to a serious complication should it penetrated to surrounding collar structures and get infected. We report a case with a serious complication. Case Report. A fourteen year–old mentally retarded boy came with a painful lump on his neck for 6 days before admission with history swallowing a fish bone 7 day before. An exploratory surgery was set for him. Intra operatively, fish bone found to have penetrated the esophageal wall and passed through the common carotid artery and internal jugular vein with a carotid–internal jugular vein–esophageal fistula. The carotid artery and internal jugular vein were resected; the esophageal fistula was then left open for a conservative treatment. He was discharged on day 56. Conclusion. The penetrated esophagus referred to the port d’ entree of deep collar compartment infection. Furthermore, fish bone penetrated further to adjacent structures. Such complication is fatal, Early diagnosis and prompt treatment should be carried out. Keywords : Vascular–esophageal fistula, carotid–jugular–esophageal fistula, migrated fish bone, deep collar abscess, esophageal perforation

Pneumothorax Secondary to an Ingested Fish Bone.

Pneumothorax Secondary to an Ingested Fish Bone.

Migratory fish bone complicating as neck abscess

<p class="abstract">Accidental ingestion of fish bone is usually uncomfortable, some cases it may be dangerous to a patient, a challenging diagnosis. A retained fish bone may have potentially disastrous complications which may affect the morbidity or mortality. Fish bone may even penetrate extra-luminally and reside in the soft tissue of the neck. Computed tomography (CT) of the neck is of great assistance in diagnosing a migrating fish bone. Surgical exploration is mandatory.</p>

A Piercing Fish Bone Through Tracheal Wall

Fish bone ingestion is a common encounter in otorhinolaryngology setting. The patient usually present with foreign body sensation and odynophagia. Owing to its sharp end in nature, migration to the surrounding structures such as thyroid gland and neck muscles and have been reported. However the migration into the trachea is an extremely rare occurrence. We present a patient with fish bone ingestion which pierced into the trachea wall which was successfully removed via bronchoscopy.International Journal of Human and Health Sciences Vol. 02 No. 01 Jan’18. Page : 35-37

Fish bone ingestion: complications and legal implications

Fish bone ingestion: complications and legal implications

A Case of Abdominal Abscess Possibly Due to Digestive Tract Perforation by an Ingested Fish Bone

A Case of Abdominal Abscess Possibly Due to Digestive Tract Perforation by an Ingested Fish Bone

Pyogenic Liver Abscess Secondary to Foreign Body (Fish Bone) Treated by Laparoscopy: A Case Report

Liver abscess due to perforation of the gastrointestinal tract by a foreign body is a rare and possibly fatal event. Diagnosing this pathology is complicated by the lack of specific symptoms and unfamiliarity of ingestion by the patient and low clinical suspicion of this disease. In the case of liver abscess unresponsive to aspiration and administration of antibiotics, this hypothesis must be made, despite its low incidence. This case report describes and illustrates a case of liver abscess secondary to fish bone ingestion with consequent piercing of the lesser gastric curvature, diagnosed by computed tomography and specific anamnesis. Laparoscopy was performed to extract the foreign body, without complications; the patient is currently asymptomatic and does not present any abnormal physical examination findings. We believe this represents the first case report of a successful laparoscopic treatment in South America for the removal of an ingested foreign body associated with pyogenic liver abscess.

魚骨によるS状結腸穿孔に対し内視鏡的魚骨除去により保存的に治療し得た1例

魚骨によるS状結腸穿孔に対し内視鏡的魚骨除去により保存的に治療し得た1例

Surgical outcome of impacted artificial denture in esophagus

Introduction and objective Foreign body getting lodged in esophagus is quite common, commonly due to ingestion of coin, pin, fish bone and meat. But accidental ingestion of artificial denture is a less often found condition. This paper studies the etiology, management, complications and final outcome of denture obstructing the esophagus.

Emergency department consultations due to foreign body ingestion

Abstract Introduction Foreign body (FB) ingestion is an uncommon reason for going to the Paediatric Emergency Department (PED). The aim of this study was to assess the clinical and epidemiological characteristics of foreign body ingestion and the management of these patients. Patients and methods Retrospective study, including children under 14 years old with suspected foreign body ingestion seen in the PED between 2010 and 2013. An analysis was made of the circumstances of the FB ingestion, its management in the PED, and patient outcomes. Results Of the 226.666 presentations recorded, 1.608 (0.7%) were for a FB, 970 corresponding to ingestion of mainly fish bones (367, 38.7%) and coins (181, 18.7%), except in children under 1 year (plastic objects). The median age was 4.7 years, with boys being more common in those older than 4 years (58.5%). A total of 557 patients (57.3%) reported some symptom, and complementary tests were performed in 414 (42.7%). Another specialist was called in 315 (32.4%) cases, mainly from Ear, Nose and Throat (fish bones) or Surgery (coins). The FB was removed in 305 (31.4%) cases, which were mostly fish bones or sunflower seeds. Seventy-one patients (7.3%) were admitted, especially ingestion of fish bones or coins. No patient died. Discussion Ingestion of fish bones or coins by young children is a relatively common presentation in the PED, and it is associated with frequent medical interventions. Although the overall prognosis is good, improving the health education of the population should be considered to reduce the frequency of these episodes.

Management of fish bone impaction in throat – Our experiences in a tertiary care hospital of eastern India

ObjectiveTo find out prevalence of accidental ingestion of fish bones and its management in a tertiary care hospital of eastern India. Materials & methodsThis is a prospective observational study. Three hundred thirty patients with complains of fish bone in throat who presented to the out patients department of Otorhinolaryngology and the emergency department of a Medical college between January 2008 to December 2015 were shortlisted for study. Followed by conventional examination, most were subjected to endoscopic examination and removal. The parameters analyzed were age and sex distribution, clinical presentation, duration of symptoms, location of impaction, conventional and endoscopic removal techniques. ResultAmong three hundred thirty patients, no foreign body was found in eighty patients. Patients in age group of 21–30years were affected mostly with almost equal sex distribution. Most patients presented with foreign body sensation in throat of short duration with precise finger point localization. Both conventional and endoscopic methods were employed with successful results but with definite advantage of endoscopic method. ConclusionFish bone in throat is a common occurrence in Otorhinolaryngological practice. Fish bone impaction is a common foreign body in the pharynx. Endoscopic removal is distinctly more helpful than the conventional ones.

Gastric Perforation due to Fish Bone Ingestion: a Case Report

A 74‐year‐old man was admitted to our hospital due to low‐grade fever and severe epigastric pain. Abdominal computed tomography revealed a linear structure surrounded by a small amount of air that had pierced the angular region of the gastric wall. Esophagogastroduodenoscopy showed that the structure was a fish bone. Gastric perforation due to fish bone ingestion is rare and almost all of the cases need surgical procedures. In this case, we endoscopically removed the foreign body with forceps and clipped the hole. Antimicrobial therapy was performed for one week, and the symptoms were completely improved.

Pseudoaneurisma carotídeo en niño de 2 años, complicación de la lesión esofágica por cuerpo extraño: reporte de caso y revisión de la literatura

The extracranial carotid aneurysm is a rare occurrence in clinical practice, as it involves all layers of the arterial wall. A pseudoaneurysm occurs when there are only one or two layers involved, and may be secondary to inflammatory, traumatic, or iatrogenic processes. A total of 30 cases in the paediatric population were reported in the literature between 1984 and 2016. Determining the diagnosis of this disease is difficult, and requires medical expertise to identify the findings that can guide the decision-making process in these cases.The case is reported of a 2 year-old male patient who showed symptoms characteristic of gastroenteritis. The patient was discharged, and then returned with respiratory symptoms characteristic of pneumonia that progressed to respiratory failure and required mechanical ventilation and vasoactive agents. The patient was diagnosed with a pseudoaneurysm, that was surgically treated, but no improvements were noticed. Different studies were performed that showed oesophageal perforation and mediastinitis secondary to a fishbone ingestion. The patient had massive bleeding and as a result, he died.

Abdominal manifestations of fishbone perforation: a pictorial essay.

The present article provides an overview of the spectrum of abdominal presentations of fishbone (FB) ingestion and its complications. In image data from 9 patients, FB perforations were found in different levels of the gastrointestinal tract (GIT), including duodenal, jejunal, and sigmoid perforations; in 4 asymptomatic patients, FBs were observed in the mesentery, falciform ligament, and intestinal bowel. The main imaging features of FB perforation were focal gastric or intestinal wall thickening, fat stranding, bowel obstruction, ascites, localized pneumoperitoneum, intra-abdominal abscess, liver abscess, and a linear hyperdense structure in the abdominal cavity in the GIT or within a parenchymal organ often surrounded by inflammatory changes. Free pneumoperitoneum was rare. Although in most cases, a FB does not cause any serious complications, an inflammatory process and complications may occur when it perforates the stomach or bowel loops. Radiologists need to be aware of the possibility of FB perforation, especially in high-risk patients, because it is not always considered in the differential diagnosis by referring physicians and can mimic other inflammatory conditions and tumoral lesions.

An Elusive Fishbone: The Role for Repeat Imaging and Rigid Endoscopy

Accidental ingestion of fish bones with fear of oropharyngeal or esophageal impaction is a common emergency room presentation. Only 20-30% of patients, however, will have a confirmed retained fish bone. Sharp objects in the esophagus are a medical emergency given the risks of potentially fatal complications to include esophageal perforation, bacteremia, abscess and esophageal-aortic or tracheoesophageal fistula formation. Radiographic studies are recommended to localize foreign bodies as well as to evaluate for signs of perforation. We present a 50-year-old female with CT images confirming a fish bone impacted in the cervical esophagus despite normal flexible endoscopy. Our aim is to highlight the elusive nature of impacted fish bones and their appropriate management. A 50-year-old female with history of anxiety and dysphagia, presents with a suspected retained fishbone and odynophagia. She had a normal EGD one year prior to presentation. The patient was uncomfortable and drooling with a persistent foreign body sensation. An oral exam did not reveal any foreign bodies. A CT scan confirmed a 2.7cm linear density with a punctate focus of air. Otolaryngology performed a flexible laryngoscopy but did not identify the bone or any signs of trauma. Gastroenterology was then consulted for an EGD which was unremarkable. A repeat CT scan confirmed the bone had not passed and was still in the proximal esophagus. Rigid endoscopy was subsequently performed with successful removal of a 2.7 cm fish bone buried in the right posterolateral cervical esophageal wall. The patient was admitted, started on prophylactic antibiotics, and was discharged home the next day without complications. The majority of fish bones will become lodged in the oropharynx, posterior tongue, pyriform sinuses or cervical esophagus. Traditionally, impactions in the cervical esophagus and oropharynx can be removed with flexible endoscopy. Our case demonstrates the value of repeat imaging and potentially rigid endoscopy when flexible endoscopy fails to localize or remove a foreign body. Given the elusive nature of fish bones and the significant potential complications of this condition, providers should maintain a high index of suspicion even with negative flexible endoscopy.Figure 1Figure 2Figure 3