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Development of an abdominal wall abscess caused by fish bone ingestion: a case report.
Journal of Medical Case Reports ( IF 0.9 ) Pub Date : 2019-12-15 , DOI: 10.1186/s13256-019-2301-7
Kiyomitsu Kuwahara 1 , Yasuji Mokuno 1 , Hideo Matsubara 1 , Hirokazu Kaneko 1 , Mikihiro Shamoto 2 , Shinsuke Iyomasa 1
Affiliation  

BACKGROUND A small percentage of patients with foreign body ingestion develop complications, which have a variety of clinical presentations. Less than 1% of cases require surgical intervention. We present a patient with an abdominal wall abscess resulting from a fish bone that pierced the cecum. The patient was treated laparoscopically. CASE PRESENTATION A 55-year-old Japanese man presented to our hospital with a complaint of right lower abdominal pain. A physical examination revealed tenderness, swelling, and redness at the right iliac fossa. Computed tomography showed a low-density area with rim enhancement in his right internal oblique muscle and a hyperdense 20 mm-long pointed object in the wall of the adjacent cecum. Based on the findings we suspected an abdominal wall abscess resulting from a migrating ingested fish bone. He was administered antibiotics as conservative treatment, and the abscess was not seen on subsequent computed tomography. Two months after the initial treatment, he presented with the same symptoms, and a computed tomography scan showed the foreign body in the same location as before with the same low-density area. We diagnosed the low-density area as recurrence of the abdominal wall abscess. He underwent laparoscopic surgery to remove the foreign body. His appendix, and part of his cecum and the parietal peritoneum that included the foreign body, were resected. He had an uneventful postoperative course, and at 1 year after the surgery, the abdominal wall abscess had not recurred. CONCLUSIONS An abdominal wall abscess developed in association with the migration of an ingested fish bone. We suggest that a laparoscopic surgical resection of the portion of the bowel that includes the foreign body is a useful option for selected cases.

中文翻译:

鱼骨食入引起的腹壁脓肿的发展:一例报告。

背景技术一小部分具有异物摄入的患者会发生并发症,这些并发症具有多种临床表现。不到1%的病例需要手术干预。我们向患者介绍了由于刺穿盲肠的鱼骨而引起的腹壁脓肿。病人接受了腹腔镜治疗。病例介绍一名55岁的日本男子因右下腹疼痛而到我们医院就诊。体格检查发现右侧窝有压痛,肿胀和发红。计算机体层摄影术显示低密度区域,其右斜内肌边缘增强,在邻近盲肠壁上有一个20毫米长的高密度尖头物体。根据调查结果,我们怀疑是由于鱼骨迁移引起的腹壁脓肿。他接受了抗生素作为保守治疗,在随后的计算机体层摄影术中未见脓肿。初始治疗两个月后,他表现出相同的症状,计算机断层扫描显示异物位于与以前相同的位置,且具有相同的低密度区域。我们将低密度区域诊断为腹壁脓肿的复发。他接受了腹腔镜手术以清除异物。切除了他的阑尾以及盲肠和包括异物在内的顶叶腹膜的一部分。他的术后过程平稳,在手术后的一年,腹壁脓肿没有复发。结论腹壁脓肿是由于摄入的鱼骨迁移引起的。
更新日期:2019-12-15
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