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Symeonidis D, Koukoulis G, Baloyiannis I, et al. Ingested fish bone: an unusual mechanism of duodenal perforation and pancreatic trauma. Case Rep Gastrointest Med. 2012;2012:308510doi: 10.1155/2012/308510.
Symeonidis, D., Koukoulis, G., Baloyiannis, I., Rizos, A., Mamaloudis, I., & Tepetes, K. (2012). Ingested fish bone: an unusual mechanism of duodenal perforation and pancreatic trauma. Case reports in gastrointestinal medicine, 2012308510. https://doi.org/10.1155/2012/308510
Symeonidis, Dimitrios, et al. "Ingested fish bone: an unusual mechanism of duodenal perforation and pancreatic trauma." Case reports in gastrointestinal medicine vol. 2012 (2012): 308510. doi: https://doi.org/10.1155/2012/308510
Symeonidis D, Koukoulis G, Baloyiannis I, Rizos A, Mamaloudis I, Tepetes K. Ingested fish bone: an unusual mechanism of duodenal perforation and pancreatic trauma. Case Rep Gastrointest Med. 2012;2012:308510. doi: 10.1155/2012/308510. Epub 2012 Aug 05. PMID: 22919520; PMCID: PMC3420078.
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Case Rep Gastrointest Med. 2012;2012:308510. doi: 10.1155/2012/308510. Epub 2012 Aug 05.

Ingested fish bone: an unusual mechanism of duodenal perforation and pancreatic trauma.

Case reports in gastrointestinal medicine

Dimitrios Symeonidis, Georgios Koukoulis, Ioannis Baloyiannis, Apostolos Rizos, Ioannis Mamaloudis, Konstantinos Tepetes

Affiliations

  1. Department of General Surgery and Radiology, University Hospital of Larissa, Mezourlo, 41110 Larissa, Greece.

PMID: 22919520 PMCID: PMC3420078 DOI: 10.1155/2012/308510

Abstract

Ingestion of gastrointestinal foreign bodies represents a challenging clinical scenario. Increased morbidity is the price for the delayed diagnosis of complications and timely treatment. We present a case of 57-year-old female patient which was admitted in the emergency room department complaining of a mid-epigastric pain over the last twenty-four hours. Based on the patient's history, physical examination and elevated serum amylase levels, a false diagnosis of pancreatitis, was initially adopted. However, a CT scan confirmed the presence of a radiopaque foreign body in the pancreatic head and the presence of air bubbles outside the intestinal lumen. The patient was unaware of the ingestion of the foreign body. At laparotomy, after an oblique duodenotomy, a fish bone pinned in the pancreatic head after the penetration of the medial aspect of the second portion of the duodenal wall was identified and successfully removed. The patient had an uneventful postoperative recovery. Wide variation in clinical presentation characterizes the complicated fish bone ingestions. The strategically located site of penetration in the visceral wall is responsible for the often extraordinary gastrointestinal tract injury patterns. Increased level of suspicion is of paramount importance for the timely diagnosis and treatment.

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