Perforation of the Sigmoid Colon by an Ingested Fish Bone

Masaki Watanabe, Tadayuki Kou, Yoshihiro Nishikawa, Yojiro Sakuma, Nanae Kumagai, Yayoi Oda, Yoko Kato, Yasushi Kudo, Atsushi Yamauchi, Yasushi Sugiura, Shinya Ohashi, Masanori Asada (+3 others)
2010 Internal medicine (Tokyo. 1992)  
P i c t u r e 1 . Ab d o mi n a l CT r e v e a l e d a r a d i o d e n s e l i n e a r f o r e i g n b o d y t h a t e x t e n d e d t r a n s mu r a l l y t h r o u g h t h e s i g mo i d c o l o n wa l l . P i c t u r e 2 . An e n d o s c o p i c e x a mi n a t i o n d e mo n s t r a t e d a f i s h b o n e s t u c k i n t h e s i g mo i d c o l o n wa l l . P i c t u r e 3 . T h e 3 c m f i s h b o n e a f t e r r e mo v a l b y e n d o s c o p y . A 61-year-old man was admitted to our
more » ... mitted to our hospital with a six-day history of abdominal pain in the left lower quadrant. On admission, his physical examination was unremarkable except for left lower abdominal tenderness to palpation with a slight peritoneal sign. Computed tomography (CT) of the abdomen showed multiple diverticula in the sigmoid colon with a very small amount of free air. Acute diverticulitis was diagnosed, and he received antibiotics intravenously. After admission his condition improved, but his left lower abdominal discomfort continued. On the fifth hospital day, CT of the abdomen revealed a radiodense linear foreign body measuring 3 cm that extended transmurally through the sigmoid colon wall (Picture 1, arrow) . Sigmoidoscopy demonstrated a fish bone stuck in the sigmoid colon wall (Picture 2). The fish bone was removed carefully with a snare (Picture 3). Perforation of the sigmoid colon by an ingested fish bone was diagnosed finally. Immediately after
doi:10.2169/internalmedicine.49.3438 pmid:20519824 fatcat:d4pow3htpngjznyufdt2jaa6v4