Laparoscopically detected and nonsurgically managed ileal perforation by an ingested fish bone: a case report.
| Title: | Laparoscopically detected and nonsurgically managed ileal perforation by an ingested fish bone: a case report. |
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| Authors: | Chandrasinghe PC; Department of Surgery, University of Kelaniya, North Colombo Teaching Hospital, Ragama, 11010, Sri Lanka. pramodh@sltnet.lk.; Pathirana CK; District General Hospital, Homagama, 10200, Sri Lanka. ckpathirana@yahoo.com. |
| Source: | Journal of medical case reports [J Med Case Rep] 2015 Feb 25; Vol. 9, pp. 43. Date of Electronic Publication: 2015 Feb 25. |
| Publication Type: | Case Reports; Journal Article |
| Language: | English |
| Journal Info: | Publisher: BioMed Central Country of Publication: England NLM ID: 101293382 Publication Model: Electronic Cited Medium: Internet ISSN: 1752-1947 (Electronic) Linking ISSN: 17521947 NLM ISO Abbreviation: J Med Case Rep Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: [London] : BioMed Central, [2007- |
| MeSH Terms: | Foreign Bodies/*diagnosis ; Ileum/*surgery ; Intestinal Perforation/*diagnosis ; Laparoscopy/*methods; Appendicitis/diagnosis ; Intestinal Perforation/therapy ; Appendectomy ; Diagnosis, Differential ; Humans ; Male ; Middle Aged |
| Abstract: | Introduction: Ileal perforation due to fish bone is a rare event. The condition is difficult to diagnose due to lack of specific clinical features and low sensitivity of imaging techniques. We report a case of ileal perforation by a fish bone that was detected laparoscopically and managed nonsurgically.; Case Presentation: A 45-year-old Sinhalese man presented with acute onset right iliac fossa pain and fever for three days. On examination, he had significant right iliac fossa tenderness and guarding. His white cell count and C-reactive protein level were elevated and an ultrasound scan was indicative of a bowel mass formation. A clinical diagnosis of acute appendicitis was made and laparoscopic appendicectomy was scheduled. At initial survey, a thin spike-like structure was retrieved from the bowel mass, which was revealed to be a fish bone. Our patient was managed with antibiotics only and did not develop any complications.; Conclusions: Ileal perforation due to fish bone is a rare condition that can mimic common conditions like appendicitis. Preoperative diagnosis is rarely made. The slow process of fish bone migration results in concomitant sealing of the perforation, reducing contamination. Use of laparoscopy may be useful in diagnosing this condition and preventing the morbidity of laparotomy in these patients. |
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| Entry Date(s): | Date Created: 20150419 Date Completed: 20160126 Latest Revision: 20181113 |
| Update Code: | 20260130 |
| PubMed Central ID: | PMC4349716 |
| DOI: | 10.1186/s13256-015-0526-7 |
| PMID: | 25888949 |
| Database: | MEDLINE |
Case Reports; Journal Article