Fishbone perforation of the small bowel mimicking internal herniation and obstruction in a patient with previous gastric bypass surgery

A case report of extremely rare case of fishbone penetration from stomach into spleen, causing splenic abscess, managed by spleen preserving surgery

INTRODUCTION

Fishbone penetrating from the stomach into the spleen, causing a splenic abscess, is an extremely rare condition.

CASE PRESENTATION

We report a case of fishbone penetration from the stomach into the spleen, presenting as a splenic abscess and acute peritonitis, diagnosed pre-operatively with a contrast-enhanced CT scan of the abdomen and subsequently managed with spleen-preserving surgery.

DISCUSSION

Fishbone penetration from the stomach into the spleen, causing a splenic abscess, which is an extremely rare occurrence. We successfully diagnosed and managed this case with spleen-preserving surgery, and the patient recovered well.

CONCLUSION

A rare case of fishbone penetration from the stomach into the spleen causing a splenic abscess was diagnosed radiologically pre-operatively and managed by a spleen-preserving procedure.

Submucosal protuberance caused by a fish bone in the absence of preoperative positive signs: A case report

BACKGROUND

Submucosal protuberance caused by fish bone insertion into the digestive tract has rarely been reported. These cases usually include patients with clear signs such as a history of fish intake, pain, and dysphagia, as well as positive findings on endoscopy and imaging. Here, we report a case of a fish bone hidden in the submucosal protuberance of the gastric antrum during endoscopic submucosal dissection without preoperative obvious positive signs.

CASE SUMMARY

A 58-year-old woman presented with epigastric pain for the past 20 d and a submucosal protuberance. Abdominal computed tomography and endoscopic ultrasonography did not indicate the presence of a fish bone. We assumed the cause to be an ordinary submucosal eminence and performed an endoscopic submucosal dissection to confirm its essence. During the operation, a fish bone approximately 20 mm in length was found incidentally.

CONCLUSION

Our report could potentially prevent the oversight of embedded fish bones and associated adverse effects in patients with similar presentation.