Fish Bone Perforation Mimicking Acute Appendicitis

Alex M Almoudaris, Andre Chow, Sashin Kaneria, Zainab Jiyad, Dimitri J Hadjiminas


Fish bone ingestion is relatively common, however, resultant perforation of the small bowel is fortunately rare. We present a case of a 48-year-old gentleman who attended our emergency department complaining of severe, unrelenting right lower abdominal pain for the preceding five hours. CT scanning suggested a perforated appendix however at operation the appendix was normal. Several loops of small bowel walling off an inter-loop abscess and a fishbone were discovered in the washout fluid. A diagnosis of small bowel fish bone perforation was made intra-operatively and the patient subsequently made a full recovery without the need for bowel resection. We present this as a rare case of small bowel perforation by a fish bone where the site of perforation was unidentifiable but was treated successfully without the need for bowel resection.

J Med Cases. 2011;2(6):296-299


Fishbone; Perforation; Appendix; Bowel

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