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Colonic Fishbone-Induced Perforation Involving a Penile Colorectal Carcinoma: A Case Report
Akira Imoto1,2, Yuki Nagata3, Yoshinori Shinohara1,2
1Department of Internal Medicine, Aoyama Hospital, Fujiidera, Japan.
Introduction:
Fishbone (FB) ingestion is a rare cause of gastrointestinal perforation. Herein, we report a case of FB-induced colonic perforation, in which the presence of a penile colonic carcinoma may have contributed to the development of the perforation.
Case Presentation:
An 83-year-old man was admitted to our hospital with severe abdominal pain during bowel movement. Computed tomography (CT) yielded a diagnosis of sigmoid colonic perforation due to FB and secondary peritonitis. Preoperative endoscopic examination suggested that the perforation was associated with a stalked colon tumor in the vicinity. After undergoing low anterior resection and sigmoid colostomy, the patient is currently doing well.
Conclusion:
The incidence of FB-induced colorectal-cancer-related perforation is expected to increase in the future owing to an aging society, the increase in the rates of colorectal cancer, and increase in fish consumption. This rare case suggests that preoperative examinations are important and that even relatively small polyps can contribute to gastrointestinal perforation caused by FBs. Older individuals should exercise caution during fish ingestion.
Insights
Fishbone (FB) ingestion can cause rare gastrointestinal perforations, especially in older adults with colon cancer. Early detection and caution during fish consumption are crucial for preventing such serious complications.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Radiology
Background:
- Fishbone (FB) ingestion is an uncommon cause of gastrointestinal (GI) perforation.
- Colorectal cancer incidence is rising, particularly in aging populations.
- Increased fish consumption may lead to a higher prevalence of FB-related complications.
Purpose of the Study:
- To report a rare case of colonic perforation caused by FB ingestion.
- To highlight the potential role of co-existing colon cancer in FB-induced perforation.
- To emphasize the importance of preoperative evaluation in such cases.
Main Methods:
- Case report of an 83-year-old male with sigmoid colonic perforation.
- Diagnosis confirmed by Computed Tomography (CT) and preoperative endoscopy.
- Surgical intervention included low anterior resection and sigmoid colostomy.
Main Results:
- CT scan revealed sigmoid colonic perforation secondary to FB and peritonitis.
- Endoscopy identified a stalked colon tumor near the perforation site.
- The patient recovered well following surgical treatment.
Conclusions:
- FB-induced colorectal cancer-related perforation incidence may increase due to demographic and dietary trends.
- This case underscores the significance of preoperative examinations, even for small polyps.
- Older individuals are advised to exercise caution when consuming fish to prevent GI perforation.
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