title: Abdominal manifestations of fishbone perforation: a pictorial essay.
abstract: The present article provides an overview of the spectrum of abdominal presentations of fishbone (FB) ingestion and its complications.
  
  
  
  In image data from 9 patients, FB perforations were found in different levels of the gastrointestinal tract (GIT), including duodenal, jejunal, and sigmoid perforations; in 4 asymptomatic patients, FBs were observed in the mesentery, falciform ligament, and intestinal bowel.
  
  
  
  The main imaging features of FB perforation were focal gastric or intestinal wall thickening, fat stranding, bowel obstruction, ascites, localized pneumoperitoneum, intra-abdominal abscess, liver abscess, and a linear hyperdense structure in the abdominal cavity in the GIT or within a parenchymal organ often surrounded by inflammatory changes. Free pneumoperitoneum was rare.
  
  
  
  Although in most cases, a FB does not cause any serious complications, an inflammatory process and complications may occur when it perforates the stomach or bowel loops. Radiologists need to be aware of the possibility of FB perforation, especially in high-risk patients, because it is not always considered in the differential diagnosis by referring physicians and can mimic other inflammatory conditions and tumoral lesions.
authors.affiliation: Radiology Department, Hospital Sirio-Libanes, Rua Dona Adma Jafet, 115-Bela Vista, São Paulo, SP, 01308-050, Brazil. dra.tassiapaixao@gmail.com.
authors.forename: Tassia Soraya Araujo
authors.initials: TS
authors.lastname: Paixão
authors.affiliation: Radiology Department, Hospital Sirio-Libanes, Rua Dona Adma Jafet, 115-Bela Vista, São Paulo, SP, 01308-050, Brazil.
authors.forename: Renata Vidal
authors.initials: RV
authors.lastname: Leão
authors.affiliation: Radiology Department, Hospital Sirio-Libanes, Rua Dona Adma Jafet, 115-Bela Vista, São Paulo, SP, 01308-050, Brazil.
authors.forename: Natally
authors.initials: N
authors.lastname: de Souza Maciel Rocha Horvat
authors.affiliation: Radiology Department, Hospital Sirio-Libanes, Rua Dona Adma Jafet, 115-Bela Vista, São Paulo, SP, 01308-050, Brazil.
authors.forename: Publio Cesar Cavalcante
authors.initials: PC
authors.lastname: Viana
authors.affiliation: Radiology Department, Hospital Sirio-Libanes, Rua Dona Adma Jafet, 115-Bela Vista, São Paulo, SP, 01308-050, Brazil.
authors.forename: Claudia
authors.initials: C
authors.lastname: Da Costa Leite
authors.affiliation: Radiology Department, Hospital Sirio-Libanes, Rua Dona Adma Jafet, 115-Bela Vista, São Paulo, SP, 01308-050, Brazil.
authors.forename: Rodrigo Lautert
authors.initials: RL
authors.lastname: de Azambuja
authors.affiliation: Radiology Department, Hospital Sirio-Libanes, Rua Dona Adma Jafet, 115-Bela Vista, São Paulo, SP, 01308-050, Brazil.
authors.forename: Rodrigo Sanford
authors.initials: RS
authors.lastname: Damasceno
authors.affiliation: Radiology Department, Hospital Sirio-Libanes, Rua Dona Adma Jafet, 115-Bela Vista, São Paulo, SP, 01308-050, Brazil.
authors.forename: Cinthia Denise
authors.initials: CD
authors.lastname: Ortega
authors.affiliation: Radiology Department, Hospital Sirio-Libanes, Rua Dona Adma Jafet, 115-Bela Vista, São Paulo, SP, 01308-050, Brazil.
authors.forename: Marcos Roberto
authors.initials: MR
authors.lastname: de Menezes
authors.affiliation: Radiology Department, Hospital Sirio-Libanes, Rua Dona Adma Jafet, 115-Bela Vista, São Paulo, SP, 01308-050, Brazil.
authors.forename: Giovanni Guido
authors.initials: GG
authors.lastname: Cerri
mesh_terms: D000818:Animals; D001842:Bone and Bones / Q000000981:diagnostic imaging*; D003937:Diagnosis, Differential; D005399:Fishes; D005547:Foreign Bodies / Q000000981:diagnostic imaging*; D006801:Humans; D007416:Intestinal Perforation / Q000000981:diagnostic imaging* / Q000209:etiology*
keywords: Acute abdomen; Bowel perforation; Fishbone; Foreign body