title: Small-bowel perforation caused by fish bone.
abstract: A diagnosis of small-bowel perforation, caused by a sharp or pointed foreign body, is rarely made preoperatively because the clinical symptoms are usually nonspecific and can mimic other surgical conditions, such as appendicitis and diverticulitis. We report the case of a 62-year-old woman who experienced severe pain in the right iliac fossa and fever for about five days before arrival at our hospital. The presumptive diagnosis was acute purulent appendicitis and an emergency appendectomy was planned. Swelling and erythema were noted in a segment of the small bowel in the lower right abdomen. A tiny pointed object was found penetrating the inflamed portion of the bowel, which proved to be a sharp fish bone (gray snapper). The bone was removed, followed by segmental resection of the terminal ileum and ascending colon. The postoperative course was uneventful.
authors.affiliation: Division of General Surgery, Department of Surgery, Tri-Service General Hospital, 325 Section 2, Cheng-Kung Road, Neihu 114, Taipei, Taiwan.
authors.forename: Sheng-Der
authors.initials: SD
authors.lastname: Hsu
authors.forename: De-Chuan
authors.initials: DC
authors.lastname: Chan
authors.forename: Yao-Chi
authors.initials: YC
authors.lastname: Liu
mesh_terms: D000818:Animals; D001842:Bone and Bones; D005260:Female; D005399:Fishes; D005547:Foreign Bodies / Q000150:complications*; D006801:Humans; D007416:Intestinal Perforation / Q000209:etiology*; D007421:Intestine, Small; D008875:Middle Aged