Abstract
Fish bones are the most commonly ingested structures and the most common cause of foreign body perforation of the gastrointestinal tract (GIT). Clinical presentation of foreign body GIT perforation is nonspecific, in many cases with clinical signs of acute abdomen, which can mimic appendicitis, diverticulitis, ulcer peptic disease, and other common inflammatory conditions. Besides, patients commonly do not refer that a fish bone was swallowed. Since this condition is usually not suspected by referring physicians of the emergency department (ED), radiologists play a key role in this diagnosis; the spectrum of these imaging features must be known in order to be accurately reported in the ED.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Goh BKP, Tan YM, Lin SE, Chow PKH, Cheah FK, Ooi LLPJ, Wong WK (2006) CT in the preoperative diagnosis of fish bone perforation of the gastrointestinal tract. AJR Am J Roentgenol 187:710–714. https://doi.org/10.2214/AJR.05.0178
McCanse DE, Kurchin A, Hinshaw JR (1981) Gastrointestinal foreign bodies. Am J Surg 142:335–337. https://doi.org/10.1016/0002-9610(81)90342-1
Maleki M, Evans WE (1970) Foreign-body perforation of the intestinal tract. Report of 12 cases and review of the literature. Arch Surg 101:474–477. https://doi.org/10.1001/archsurg.1970.01340280027008
Madrona A, Hernández JAF, Prats MC, Riquelme JR, Paricio PP (2000) Intestinal perforation by foreign bodies. Eur J Surg 166:307–309. https://doi.org/10.1080/110241500750009140
Coulier B, Tancredi MH, Ramboux A (2004) Spiral CT and multidetector-row CT diagnosis of perforation of the small intestine caused by ingested foreign bodies. Eur Radiol 14:1918–1925. https://doi.org/10.1007/s00330-004-2430-1
Bathla G, Teo LLS, Dhanda S (2011) Complications of a swallowed fish bone. Indian J Radiol Imaging 21:63–68. https://doi.org/10.4103/0971-3026.76061
Hsu SD, Chan DC, Liu YC (2005) Small-bowel perforation caused by fish bone. World J Gastroenterol 11:1884–1885. https://doi.org/10.3748/wjg.v11.i12.1884
Paixão TSA, Leão RV, Horvat NSMR et al (2017) Abdominal manifestations of fishbone perforation: a pictorial essay. Abdom Radiol 42:1087–1095. https://doi.org/10.1007/s00261-016-0939-9
Almoudaris AM, Chow A, Kaneria S, Jiyad Z, Hadjiminas DJ (2011) Fish bone perforation mimicking acute appendicitis. J Med Cases 2:296–299. https://doi.org/10.4021/jmc151w
Mutlu A, Uysal E, Ulusoy L, Duran C, Selamoglu D (2012) A fish bone causing ileal perforation in the terminal ileum. Ulus Travma Acil Cerrahi Derg 18:89–91. https://doi.org/10.5505/tjtes.2011.90912
Goh BK, Jeyaraj PR, Chan HS et al (2004) A case of fish bone perforation of the stomach mimicking a locally advanced pancreatic carcinoma. Dig Dis Sci 49:1935–1937. https://doi.org/10.1007/s10620-004-9595-y
Noh HM, Chew FS (1998) Small-bowel perforation by a foreign body. AJR Am J Roentgenol 171:1002. https://doi.org/10.2214/ajr.171.4.9762984
Ngan JH, Fok PJ, Lai EC, Branicki FJ, Wong J (1989) A prospective study on fish bone ingestion: experience of 358 patients. Ann Surg 211:459–462. https://doi.org/10.1097/00000658-199004000-00012
Yeung KW, Chang MS, Hsiao CP (2011) Preoperative imaging diagnosis of fish bone perforation of the gastrointestinal tract. J Radiol Sci 36:215–219
Nicolodi GC, Trippia CR, Caboclo MFFS, Castro FG, Miller WP, Lima RR, Tazima L, Geraldo J (2016) Intestinal perforation by an ingested foreign body. Radiol Bras 49(5):295–299. https://doi.org/10.1590/0100-3984.2015.0127
Stoker J, van Randen A, Laméris W, Boermeester M (2009) Imaging patients with acute abdominal pain. Radiology 253:31–46. https://doi.org/10.1148/radiol.2531090302
Kessner R, Barnes S, Halpern P, Makrin V, Blachar A (2017) CT for acute nontraumatic abdominal pain—is oral contrast really required? Acad Radiol 24:840–845. https://doi.org/10.1016/j.acra.2017.01.013
Venkatesh SH, Karaddi NKV (2016) CT findings of accidental fish bone ingestion and its complications. Diagn Interv Radiol 22:156–160. https://doi.org/10.5152/dir.2015.15187
Drakonaki E, Chatzioannou M, Spiridakis K, Panagiotakis G (2011) Acute abdomen caused by a small bowel perforation due to a clinically unsuspected fish bone. 17:160–162. https://doi.org/10.4261/1305-3825.DIR.3236-09.1
Hiraide T, Terada H, Saitou T, Nakamura M (2010) Penetration of a fish bone into the lower gastric body through the antrium. J Jpn Surg Assoc 71:2592–2596. https://doi.org/10.3919/jjsa.71.2592
Aparício JD, Leichsenring C, Sobrinho C et al (2019) Supralevator abscess: new treatment for an uncommon aetiology: case report. Int J Surg Case Rep 59:128–131. https://doi.org/10.1016/j.ijscr.2019.05.016
Lee WK, Mossop PJ, Little AF, Fitt GJ, Vrazas JI, Hoang JK, Hennessy OF (2008) Infected (Mycotic) aneurysms: spectrum of imaging appearances and management. Radiol. 28:1853–1868. https://doi.org/10.1148/rg.287085054
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflict of interest.
Additional information
Publisher’s note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
e Silva, G.S., Gomes, N.B.N., Pacheco, E.O. et al. Emergency CT of abdominal complications of ingested fish bones: what not to miss. Emerg Radiol 28, 165–170 (2021). https://doi.org/10.1007/s10140-020-01800-6
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10140-020-01800-6