Repeated colon penetration by an ingested fish bone: report of a case

A 78-year-old man was admitted to Kumamoto Rosai Hospital with right lower abdominal pain. Abdominal computed tomography (CT) showed penetration of the cecum by a foreign body, which looked like a fish bone, as well as thickening of the right lower abdominal wall. We made an initial diagnosis of penetration of the colon by an ingested fish bone and the patient was managed conservatively with fasting, peripheral parental nutrition, and intravenous antibiotics. By the next day, the right lower abdominal pain had diminished and a repeat CT scan showed that the fish bone had moved to the splenic flexure. However, 2 days later, the patient complained of pain in the left upper abdomen and another CT scan showed repeated penetration of the descending colon by the same fish bone. Thus, we removed the fish bone via endoscopic extirpation. The patient had an uneventful postoperative course and was discharged home 6 days later.