Anil Khetarpal. Khetarpal Hospital
Aim: To report a case of fish bone ingestion masquerading as acute abdomen.
Case Report: A 48 years old female patient presented with complaints of severe abdominal pain since 5 days. There was no history of associated nausea or vomiting, fever or altered in bowel habits. On examination patient had tenderness and guarding localized to the right iliac fossa. Blood investigations revealed raised inflammatory markers. Ultrasound whole abdomen and Contrast Enhanced Computed Tomography (CECT) were normal. Patient was managed conservatively but in view of persistence of symptoms a triple puncture diagnostic laparoscopy was performed on day 3 of admission. Omental inflammation with soapy appendix was found and appendicectomy was performed. On further assessment a foreign body was also found in the ileum which was removed and identified as a fish bone. Patient had a satisfactory post operative recovery and was discharged in stable condition.
Discussion: Acute abdomen due to fish bone ingestion is not a very common occurrence. Unfortunately the history is often non-specific and these people can be misdiagnosed with acute appendicitis & other pathologies. CT scans can be useful to aid diagnostics. It is however not fully sensitive in detecting complications arising from fishbone ingestion.
Conclusion: Any patient with acute abdomen, with non-specific history and normal imaging may still benefit from a diagnostic laparoscopy.
Key Words: bone ingestion, acute abdomen, foreign body ingestion
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 86981
Program Number: P162
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster