A Fish Bone Migrating into the Peritoneal Cavity.

An 81-year-old man was admitted for a chief complaint of right lower abdominal pain. Abdominal computed tomography showed a linear high-density object in the ileum (Picture 1a). Double-balloon enteroscopy (DBE) found two pinholes in the small intestinal lumen bilaterally in the ileum (Picture 1b). The pinholes were considered signs that a fish bone had penetrated the intestinal wall and disappeared.

Picture 1.

The intraoperative findings revealed that a fish bone had migrated to the peritoneal cavity after penetrating the abdominal wall approximately 70 cm proximal to the ileo-cecal valve (Picture 2). Segmental resection of the small intestine was performed. Among ingested foreign bodies, fish bones are the most commonly observed objects leading to bowel perforation (1), and recently, the removal of fish bones by DBE has been reported (2). This case reminds us that the possibility of migration should always be considered if sharp objects, such as fish bones, are ingested.

Picture 2.

The authors state that they have no Conflict of Interest (COI).