Tufan EGELİ, Mücahit ÖZBİLGİN, Mustafa Mahmut BARIŞ, Mustafa SEÇİL, Naciye Sinem GEZER

Intestinal perforation due to ingestion of fish bone

Gastrointestinal sistemin yabancı cisim yutmaya bağlı gelişen perforasyonu %1 den az görülen nadir bir durumdur. Balık kılçığı, uzun ve keskin uçlu olması nedeniyle gastrointestinal system perforasyonuna en sık yol açan yabancı cisimdir. Yabancı cisim yutmaya bağlı gelişen perforasyon, belirtilerinin nonspesifik ve geniş bir spektrumda olması ve hastaların genellikle yabancı cisim yuttuğunu hatırlamaması nedeniyle operasyon öncesinde koyulması zor bir tanıdır. Ancak akut abdominal bulgularla baş vuran hastalarda her zaman akılda tutulmalıdır. Bu olgu sunumunda, balık kılçığına bağlı intestinal perforasyon olgusunun çok kesitli blgisayarlı tomografi bulguları sunulacaktır. Çok kesitli blgisayarlı tomografi sayesinde, yabancı cisim yutma öyküsü bulunmayan hastada operasyon öncesinde yabancı cisme bağlı intestinal perforasyon tanısı koyulmuş ve derhal uygun cerrahi tedavi yapılmıştır

Balık kılçığına bağlı intestinal perforasyon

Perforation of the gastrointestinal tract by accidently ingested foreign bodies is rare, occurring in less than 1% of the patients. Fish bones are the most common foreign bodies leading gastrointestinal tract perforation due to their elongated shape end sharp ends. Preoperative diagnosis of the gastrointestinal tract perforation by foreign body is challenging since the patients present with a wide and nonspecific spectrum of symptoms and usually don’t recall ingestion of the foreign body. It should always be kept in mind in cases with acute abdominal complaint. Herein, we present multidetector computed tomography findings of a case with bowel perforation due to fish bone. Thus, computed tomography scan revealed the foreign body with perforated intestinal segment, led prompt diagnosis and optimal surgical treatment even in a patient with no preoperative history of foreign body ingestion

PDF

___

1. Sheng-Der Hsu, De-Chuan Chan, Yao-Chi Liu. Small-bowel perforation caused by fish bone. World J Gastroenterol. 2005;11:1884-5.
2. Goh BK, Tan YM, Lin SE, Chow PK, Cheah FK, Ooi LL et al. CT in the preoperative diagnosis of fish bone perforation of the gastrointestinal tract. AJR Am J Roentgenol. 2006;187:710-4.
3. Emir S, Özkan Z, Altınsoy BH, Yazar FM, Sözen S, Bali İ. Ingested bone fragment in the bowel: Two cases and a review of the literature. World J Clin Cases. 2013;1:212-6.
4. Joglekar S, Rajput I, Kamat S, Downey S. Sigmoid perforation caused by an ingested chicken bone presenting as right iliac fossa pain mimicking appendicitis: a case report. J Med Case Rep. 2009;3:7385.
5. Eisen GM, Baron TH, Dominitz JA, Faigel DO, Goldstein JL, Johanson JF et al. Guideline for the management of ingested foreign bodies. American Society for Gastrointestinal Endoscopy. Gastrointest Endosc. 2002;55:802-6.
6. Madrona AP, Hernández JAF, Prats MC, Riquelme JR, Parrila Paricio P. Intestinal perforation by foreign bodies. Eur J Surg. 2000;166:307-9.
7. Goh BK, Chow PK, Quah HM, Ong HS, Eu KW, Ooi LL et al. Perforation of the gastrointestinal tract secondary to ingestion of foreign bodies. World J Surg. 2006;30:372-7.
8. Ell SR, Sprigg A. The radio-opacity of fish bone species variation. Clin Radiol. 1991;44:104-7.
9. Ngan JH, Fok PJ, Lai EC, Branicki FJ, Wong J. A prospective study on fish bone ingestion. Experience of 358 patients. Ann Surg. 1990;211:459-62.
10. Coulier B, Tancredi MH, Ramboux A. Spiral CT and multidetector-row CT diagnosis of perforation of the small intestine caused by ingested foreign bodies. Eur Radiol. 2004;14:1918-25.
11. Coulier B. Diagnostic ultrasonography of perforating foreign bodies of the digestive tract. J Belge Radiol. 1997;80:1-5.
12. Nylund K, Odegaard S, Hausken T, Folvik G, Lied GA, Viola I, et al. Sonography of the small intestine. World J Gastroenterol. 2009;15:1319-30.
13. Mutlu A, Uysal E, Ulusoy L, Duran C, Selamoğlu D. A fish bone causing ileal perforation in the terminal ileum. Ulus Travma Acil Cerrahi Derg. 2012;18:89- 91.