Accidental fish bone ingestion complicated by gastric abscess: A case report

The presence of a foreign object in the gastrointestinal tract is not an uncommon finding in imaging studies. Fishbone is a common foreign body that can be accidentally ingested. Most of them pass spontaneously without symptoms, while 10%-20% fail to pass and less then 1% cause complications. A 67-year-old woman presented to the emergency department with epigastric abdominal pain, dyspepsia, and weight loss over the previous weeks. Laboratory tests showed a mild elevation of inflammatory markers, while amylase and lipase levels were within normal limits. The patient was afebrile. A contrast-enhanced abdominal CT scan revealed a linear hyperdense structure within the thickness of the gastric wall at the level of the antrum; at the same site, an inhomogeneous thickening of the gastric wall with supraphysiological fluid density was observed. After antibiotic therapy, the patient underwent laparoscopic surgery with removal of the foreign body, which was identified as a fish bone, and surgical lavage She was discharged 5 days after surgery. CT is the most sensitive and specific tool for the diagnosis. Multiplanar reconstructions and the use of a bone window has proven essential for early diagnosis and therapeutic planning.