title: Migration of a fish bone into the right renal vein.
abstract: We describe a patient in whom a fish bone penetrated the duodenum and migrated into the right renal vein. The bone was successfully removed with surgery. The 75-year-old man was admitted to Nippon Medical School Tama Nagayama Hospital because of right upper abdominal pain persisting for 7 days. The patient's medical history was not relevant to the current disorder. Plain radiography showed no abnormalities. Computed tomography revealed a linear object of high intensity that had penetrated the duodenum and migrated into the right renal vein with thrombus. The object was surrounded by a low-density area, suggesting severe inflammation. The patient had eaten fish 1 day before the onset of abdominal pain. We diagnosed duodenal penetration caused by an ingested fish bone. Endoscopic examination showed erosion, but no fish bone or ulceration was detected in the duodenum. The patient was treated conservatively with fasting, peripheral parental nutrition, and intravenous antibiotics. Three days after admission, non-contrast-enhanced computed tomography showed no movement of the foreign body. The patient continued to have pain, and the decision was made to surgically explore the abdomen. Intraoperative ultrasonography showed that the foreign body had migrated completely into the right renal vein with thrombus. Severe inflammation of the right renal vein was observed. Because we could not remove the foreign body without seriously injuring the right renal vein, right nephrectomy was performed. Macroscopic examination of the surgical specimen confirmed the presence of a fish bone with thrombus in the right renal vein. The patient was discharged 9 days after operation, with no complications.
authors: Surgery for Organ Function and Biological Regulation, Graduate School of Medicine, Nippon Medical School, Japan.
authors: Takuma
authors: T
authors: Iwai
authors: Hiroshi
authors: H
authors: Yoshida
authors: Tadashi
authors: T
authors: Yokoyama
authors: Hiroshi
authors: H
authors: Maruyama
authors: Seiji
authors: S
authors: Suzuki
authors: Takeshi
authors: T
authors: Matsutani
authors: Akira
authors: A
authors: Matsushita
authors: Atsushi
authors: A
authors: Hirakata
authors: Koji
authors: K
authors: Sasajima
authors: Eiji
authors: E
authors: Uchida
mesh_terms: D000368:Aged; D000818:Animals; D001842:Bone and Bones; D005548:Foreign-Body Migration / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D007249:Inflammation / Q000150:complications / Q000473:pathology; D008297:Male; D012082:Renal Veins / Q000000981:diagnostic imaging / Q000473:pathology*; D017747:Seafood / Q000009:adverse effects*; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography