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Bajaber A, Shariff S, Azhar M, Ayashi M, Moawed M, Bajaber O. Unforeseen consequences: A case report of misdiagnosis in pediatric ingestion of a fish bone. Radiol Case Rep 2024; 19:4741-4746. [PMID: 39228950 PMCID: PMC11366894 DOI: 10.1016/j.radcr.2024.07.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2024] [Accepted: 07/13/2024] [Indexed: 09/05/2024] Open
Abstract
Children are frequently reported as cases of foreign body ingestion, with fishbone ingestion being particularly prevalent in communities where fish consumption is common. Although many instances of foreign body ingestion resolve spontaneously, the ingestion of sharp objects like fishbones poses a greater risk of morbidity and mortality due to their propensity for causing complications. Furthermore, incidents of foreign body ingestion often present with nonspecific symptoms or may go unnoticed, potentially leading to misdiagnosis and complicating the clinical course. We present a case of a 2-year-old boy initially misdiagnosed with constipation and treated with laxatives due to intermittent progressive abdominal pain. Subsequently, he presented to the emergency department where radiological and laboratory investigations revealed signs of inflammation and localized abdominal fluid collection containing a linear hyperdense object, indicating complicated foreign body ingestion with perforation. Urgent laparotomy revealed an omental abscess, which was excised, and the perforation site was repaired with sutures. This case underscores the risk of misdiagnosis and the importance of timely recognition and management. It also emphasizes the critical role of imaging, particularly computed tomography, in accurate diagnosis and differentiation from other common conditions.
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Affiliation(s)
- Abubakr Bajaber
- College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia
| | - Safa Shariff
- College of Medicine, Al-Rayan Colleges, Madinah 42541, Saudi Arabia
| | - Muhammad Azhar
- Pediatric Surgery Department, King Saud Medical City, Riyadh 12746, Saudi Arabia
| | - Mariam Ayashi
- Medical Imaging Department, Pediatric Radiology Section, King Saud Medical City, Riyadh 12746, Saudi Arabia
| | - Mohammed Moawed
- Medical Imaging Department, Pediatric Radiology Section, King Saud Medical City, Riyadh 12746, Saudi Arabia
| | - Omar Bajaber
- Medical Imaging Department, Pediatric Radiology Section, King Saud Medical City, Riyadh 12746, Saudi Arabia
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Pante L, Brito LG, Franciscatto M, Brambilla E, Soldera J. A rare cause of acute abdomen after a Good Friday. World J Clin Cases 2022; 10:9539-9541. [PMID: 36159408 PMCID: PMC9477653 DOI: 10.12998/wjcc.v10.i26.9539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 06/13/2022] [Accepted: 08/15/2022] [Indexed: 02/05/2023] Open
Abstract
Small bowel perforation caused by an ingested fish bone is rare but can involve the appendix or Meckel's diverticulum. We report the case of a 25-year-old man who presented to the emergency department with acute abdomen caused by perforation of a Meckel's diverticulum with a fish bone ingested in a Good Friday.
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Affiliation(s)
- Leticia Pante
- School of Medicine, Universidade de Caxias so Sul, Caxias do Sul 95070-560, Brazil
| | - Luísa Gailhard Brito
- School of Medicine, Universidade de Caxias so Sul, Caxias do Sul 95070-560, Brazil
| | - Miguel Franciscatto
- Proctology, Hospital Geral de Caxias do Sul, Caxias do Sul 95070-560, Brazil
| | - Eduardo Brambilla
- Clinical Gastroenterology, Universidade de Caxias do Sul, Caxias do Sul 95070-560, RS, Brazil
| | - Jonathan Soldera
- Clinical Gastroenterology, Universidade de Caxias do Sul, Caxias do Sul 95070-560, RS, Brazil
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Alanazi AB, Aldhowayan AM, Almuhanna MM, Binjawhar AS, Althobity AO. Fish bone perforation into a patent urachus mimicking urachal carcinoma: Case report. Urol Case Rep 2022; 43:102102. [PMID: 35573084 PMCID: PMC9092244 DOI: 10.1016/j.eucr.2022.102102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 04/20/2022] [Accepted: 04/28/2022] [Indexed: 02/07/2023] Open
Abstract
Ingestion of foreign body may induce complications such as perforation, impaction, or penetration. Diagnosis rarely made preoperatively due to clinical symptoms are usually nonspecific and can mimic other surgical conditions. A 69-year-old male presented to emergency department with vague abdominal pain for few days. Following a clinical evaluation and computed tomography scan of the abdomen, provisional diagnosis of urachal carcinoma was made. As the result of urachal excision with partial cystectomy including fishbone were resected, pathology revealed benign urothelium.
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Affiliation(s)
- Abdullah B. Alanazi
- Princess Nourah bint Abdulrahman University, College of medicine, Saudi Arabia
| | - Afrah M. Aldhowayan
- Princess Nourah bint Abdulrahman University, College of medicine, Saudi Arabia
| | - Mousa M. Almuhanna
- Princess Nourah bint Abdulrahman University, College of medicine, Saudi Arabia
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Hendricks A, Meir M, Hankir M, Lenschow C, Germer CT, Schneider M, Wiegering A, Schlegel N. Suppurative thyroiditis caused by ingested fish bone in the thyroid gland: a case report on its diagnostics and surgical therapy. BMC Surg 2022; 22:92. [PMID: 35272656 PMCID: PMC8908564 DOI: 10.1186/s12893-022-01542-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 03/02/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Accidental ingestion of fish bone is a common cause of otolaryngological emergency. Migration of the ingested bone into the thyroid gland, however, occurs very rarely. The associated clinical presentation, symptoms and duration of discomfort are also highly variable between patients and can be diagnostically challenging. CASE PRESENTATION Here, we report the case of a 71-year-old female patient presenting with an ingested fish bone that migrated into the right thyroid lobe as a rare cause of suppurative thyroiditis with the clinical features of sepsis. We outline the diagnostic approach, peri- and intraoperative management as well as complications. It is proposed that besides endoscopy, imaging methods such as ultrasound or computed tomography may be necessary to verify the diagnosis and location of an ingested fish bone. Prompt surgical removal of the foreign body and resection of the infectious focus is recommended to minimize the risk of local inflammation, recurrent nerve lesions and septic complications arising from the spread of infection. CONCLUSION Fish bone migration into the thyroid gland is an extremely rare event, the successful detection and surgical management of which can be achieved through a careful interdisciplinary approach.
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Affiliation(s)
- Anne Hendricks
- Department of General, Visceral, Transplant, Vascular and Pediatric Surgery, University Hospital Wuerzburg, Oberduerrbacherstrasse 6, 97080, Wuerzburg, Germany
| | - Michael Meir
- Department of General, Visceral, Transplant, Vascular and Pediatric Surgery, University Hospital Wuerzburg, Oberduerrbacherstrasse 6, 97080, Wuerzburg, Germany
| | - Mohammed Hankir
- Department of General, Visceral, Transplant, Vascular and Pediatric Surgery, University Hospital Wuerzburg, Oberduerrbacherstrasse 6, 97080, Wuerzburg, Germany
| | - Christina Lenschow
- Department of General, Visceral, Transplant, Vascular and Pediatric Surgery, University Hospital Wuerzburg, Oberduerrbacherstrasse 6, 97080, Wuerzburg, Germany
| | - Christoph-Thomas Germer
- Department of General, Visceral, Transplant, Vascular and Pediatric Surgery, University Hospital Wuerzburg, Oberduerrbacherstrasse 6, 97080, Wuerzburg, Germany
| | - Michael Schneider
- Institute of Pathology, University of Wuerzburg, Josef-Schneider-Str. 2, 97080, Wuerzburg, Germany
| | - Armin Wiegering
- Department of General, Visceral, Transplant, Vascular and Pediatric Surgery, University Hospital Wuerzburg, Oberduerrbacherstrasse 6, 97080, Wuerzburg, Germany
| | - Nicolas Schlegel
- Department of General, Visceral, Transplant, Vascular and Pediatric Surgery, University Hospital Wuerzburg, Oberduerrbacherstrasse 6, 97080, Wuerzburg, Germany.
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Elbakouri A, Yaqine K, Bouali M, Elhattabi K, Bensardi F, Fadil A. Fish bone perforation of the small bowel: A case report. Ann Med Surg (Lond) 2021; 65:102348. [PMID: 34007443 PMCID: PMC8111590 DOI: 10.1016/j.amsu.2021.102348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 04/17/2021] [Accepted: 04/25/2021] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Fish bone is one of the most common accidently ingested foreign bodies. Normally, it is eliminated from the gastrointestinal (GI) system without any symptomatology, only 1% of the cases will develop a perforation of the GI tract requiring surgical intervention. PRESENTATION OF CASE A 70-year-old man, presented with a 48h evolving abdominal pain, important abdominal distension, nausea, vomiting, and a last bowel movement reported 2 days ago, The abdomino-pelvic CT-scan objectified a distension of the terminal ileum measured at 30mm, The exploration revealed a sharp foreign body,at the 15 proximal centimeters of the terminal ileum, which penetrated through the wall of the ileum. The foreign body was removed and we noticed that it is a fish bone. The patient recovered well. DISCUSSION Clinical manifestations are determined by the location of the perforation and the preoperative diagnosis is always difficult to reach. Computed tomography (CT) scan is the indicated method to identify ingested foreign bodies and surgery is the treatment of choice. CONCLUSION Delay in diagnosis and treatment can be associated with significant morbidity and mortality.
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Affiliation(s)
- Abdelilah Elbakouri
- Department of General Surgery, University Hospital Centre Ibn Rochd, Casablanca, Morocco
- Faculty of Medecine and Pharmacy, Hassan II University, Casablanca, Morocco
| | - Karim Yaqine
- Department of General Surgery, University Hospital Centre Ibn Rochd, Casablanca, Morocco
- Faculty of Medecine and Pharmacy, Hassan II University, Casablanca, Morocco
| | - Mounir Bouali
- Department of General Surgery, University Hospital Centre Ibn Rochd, Casablanca, Morocco
- Faculty of Medecine and Pharmacy, Hassan II University, Casablanca, Morocco
| | - Khalid Elhattabi
- Department of General Surgery, University Hospital Centre Ibn Rochd, Casablanca, Morocco
- Faculty of Medecine and Pharmacy, Hassan II University, Casablanca, Morocco
| | - Fatimazahra Bensardi
- Department of General Surgery, University Hospital Centre Ibn Rochd, Casablanca, Morocco
- Faculty of Medecine and Pharmacy, Hassan II University, Casablanca, Morocco
| | - Abdelaziz Fadil
- Department of General Surgery, University Hospital Centre Ibn Rochd, Casablanca, Morocco
- Faculty of Medecine and Pharmacy, Hassan II University, Casablanca, Morocco
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