Laparoscopic removal of an ingested fish bone that penetrated the stomach and was embedded in the pancreas: a case report

Abstract

BackgroundThe gastrointestinal tract can occasionally be perforated or penetrated by an ingested foreign body, such as a fish bone. However, there are very few reported cases in which an ingested fish bone penetrated the gastrointestinal tract and was embedded in the pancreas.Case presentationAn 80-year-old male presented with epigastric pain. Computed tomography of the abdomen showed a linear, hyperdense, foreign body that penetrated through the posterior wall of the gastric antrum. There was no evidence of free air, abscess formation, migration of the foreign body into the pancreas, or pancreatitis. As the patient had a history of fish bone ingestion, we made a diagnosis of localized peritonitis caused by fish bone penetration of the posterior wall of the gastric antrum. We first attempted to remove the foreign body endoscopically, but failed because it was not detected. Hence, an emergency laparoscopic surgery was performed. A linear, hard, foreign body penetrated through the posterior wall of the gastric antrum and was embedded in the pancreas. The foreign body was safely removed laparoscopically and was identified as a 2.5-cm-long fish bone. Intraperitoneal lavage was performed, and a drain was placed in the lesser sac. The patient recovered without complications and was discharged on the 7th postoperative day.ConclusionLaparoscopic surgery could be performed safely for the removal of an ingested fish bone embedded in the pancreas.

Laparoscopic removal of an ingested fish bone from the head of the pancreas: case report and review of literature

“…A recent review of the English literature revealed only seven cases of an ingested fish bone that penetrated through the gastrointestinal tract and migrated into the pancreas [ 4 - 10 ], as demonstrated in Table 1 . In these cases, a fish bone penetrated the stomach [ 4 , 5 , 8 , 10 ] or the duodenum [ 6 , 7 , 9 ]. Open surgical approach was preferred in the 6 of them and only in one case the ingested fish bone was removed laparoscopically with great success [ 10 ].…”

“…In these cases, a fish bone penetrated the stomach [ 4 , 5 , 8 , 10 ] or the duodenum [ 6 , 7 , 9 ]. Open surgical approach was preferred in the 6 of them and only in one case the ingested fish bone was removed laparoscopically with great success [ 10 ]. CT scan is useful for detecting foreign bodies like an ingested fish bone.…”

“…It usually reveals a linear, hyperdense, foreign body corresponding to a bone [ 10 ]. On the basic of findings on CT, treatment of choice for penetration of the gastrointestinal tract by an ingested fish bone consists of endoscopic removal, surgical intervention, abscess drainage if necessary, and administration of appropriate antibiotics [ 10 ]. Early diagnosis and prompt treatment are mandatory to improve the prognosis of this rare condition.…”

Laparoscopic removal of a fishbone migrating from the gastrointestinal tract to the pancreas

“…Very few cases of an ingested fishbone that migrated into the pancreas have been published in the literature so far. 1,2 The patient recovered without complications and was discharged. Laparoscopic surgery could be performed safely for the removal of an ingested foreign body embedded in the pancreas.…”

Laparoscopic removal of an aberrant acupuncture needle in the gluteus that reached the pelvic cavity: a case report

“…However, some adverse effects such as organ injury, systemic infection, needle breakage, and forgotten needles have been reported [ 2 ]. An intrapelvic foreign body can occur due to remnants of medical procedures such as laparotomy [ 3 ], migration of orthopedic fixation devices [ 4 , 5 ], perforation of the digestive tract after accidental ingestion [ 6 ], and introduction via the transvaginal [ 7 ], transurethral [ 8 ], transanal [ 9 ], and percutaneous routes. Long-term foreign bodies in the abdominal cavity may form granulation tissue or an abscess, and may cause organ injury [ 3 ]; therefore, prompt removal is required.…”