title: Extra luminal migration of ingested fish bone to the spleen as an unusual cause of splenic rupture: Case report and literature review.
abstract: BACKGROUND
  The ingestion of foreign bodies (FB) is a common problem worldwide and affects all ages; it is, however, particularly important in the pediatric population and in mentally impaired adults. The typical outcome of FB ingestion is good, since the majority of ingested material is passed spontaneously through the gastrointestinal tract. Serious complications can occur, however, including bowel perforation or obstruction and gastrointestinal bleeding, amongst others. Extraluminal migration of ingested foreign bodies is very rare and reported cases so far have shown, more commonly, migration to neck structures, with very few reported cases of migration to the abdomen. To date, there is no reported case of extraluminal migration of ingested FB to the spleen.
  
  
  METHODS
  A 59-year-old man presented with acute abdominal pain and dyspnea. A CT scan revealed a FB within the spleen, with a ruptured capsule and perisplenic collection. Surgery was performed and a 3cm-long fishbone was extracted, with hemoperitoneum secondary to spleen rupture. The patient was discharged on the third postoperative day with good recovery and without any complications; pneumococcal polysaccharide vaccination was provided.
  
  
  CONCLUSIONS
  FB ingestion is a relatively benign condition; however, some serious complications can arise infrequently. The patient reported herein is the first in the literature to present a splenic rupture due to extra luminal migration of an ingested fish bone.
authors.affiliation: Universidad ICESI, Facultad de Medicina, Calle18#122.135, Cali, Colombia.
authors.forename: Melibea
authors.initials: M
authors.lastname: Sierra-Ruiz
authors.affiliation: Universidad ICESI, Facultad de Medicina, Calle18#122.135, Cali, Colombia.
authors.forename: Juan C
authors.initials: JC
authors.lastname: Sáenz-Copete
authors.affiliation: Centro de Investigaciones Clínicas, Carrera 95#18-75, Fundación Clínica Valle del Lili, Cali, Colombia.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Enriquez-Marulanda
authors.affiliation: Universidad ICESI, Facultad de Medicina, Calle18#122.135, Cali, Colombia; Centro de Investigaciones Clínicas, Carrera 95#18-75, Fundación Clínica Valle del Lili, Cali, Colombia; Division of Trauma and Acute Care Surgery, Department of Surgery, Fundación Valle del Lili, Carrera 98#18-49, Cali, Colombia. Electronic address: ordonezcarlosa@gmail.com.
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Ordoñez
keywords: Acute abdomen; Colon perforation; Fish bone; Foreign bodies; Foreign-body migration; Splenic rupture