title: Acute abdomen caused by a small bowel perforation due to a clinically unsuspected fish bone.
abstract: We report the case of a 78-year-old woman with a three-day history of abdominal pain and vomiting. An abdominal plain film showed a distended small bowel loop and no signs of free intra-abdominal gas. An abdominal ultrasound revealed a mass containing a linear, hyperechoic structure. The mass was connected through a sinus tract to an adjacent aperistaltic small bowel loop. A laparotomy revealed a jejunal perforation and an omental granuloma containing a fish bone. Accidentally ingested foreign bodies should always be suspected in cases of acute abdomen, and ultrasonography remains a firstline examination tool for preoperative diagnoses of unsuspected foreign bodies and their complications.
authors.affiliation: Department of Radiology, Venizeleion General Hospital, Heraklion, Greece. drakonaki@yahoo.gr
authors.forename: Eleni
authors.initials: E
authors.lastname: Drakonaki
authors.forename: Maria
authors.initials: M
authors.lastname: Chatzioannou
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Spiridakis
authors.forename: George
authors.initials: G
authors.lastname: Panagiotakis
mesh_terms: D000006:Abdomen, Acute / Q000000981:diagnostic imaging* / Q000209:etiology / Q000601:surgery; D000368:Aged; D001842:Bone and Bones / Q000000981:diagnostic imaging; D003937:Diagnosis, Differential; D005260:Female; D005547:Foreign Bodies / Q000150:complications* / Q000000981:diagnostic imaging* / Q000601:surgery; D006099:Granuloma / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D006801:Humans; D007416:Intestinal Perforation / Q000000981:diagnostic imaging* / Q000209:etiology / Q000601:surgery; D007421:Intestine, Small / Q000000981:diagnostic imaging* / Q000601:surgery; D017747:Seafood; D014463:Ultrasonography