Fish bone perforation of the small bowel: A case report

Fish bone is one of the most common accidently ingested foreign bodies. Normally, it is eliminated from the gastrointestinal (GI) system without any symptomatology, only 1% of the cases will develop a perforation of the GI tract requiring surgical intervention. A 70-year-old man, presented with a 48h evolving abdominal pain, important abdominal distension, nausea, vomiting, and a last bowel movement reported 2 days ago, The abdomino-pelvic CT-scan objectified a distension of the terminal ileum measured at 30mm, The exploration revealed a sharp foreign body,at the 15 proximal centimeters of the terminal ileum, which penetrated through the wall of the ileum. The foreign body was removed and we noticed that it is a fish bone. The patient recovered well. Clinical manifestations are determined by the location of the perforation and the preoperative diagnosis is always difficult to reach. Computed tomography (CT) scan is the indicated method to identify ingested foreign bodies and surgery is the treatment of choice. Delay in diagnosis and treatment can be associated with significant morbidity and mortality. •Perforations of the gastrointestinal (GI) tract due to an ingested fish bone (FB) are rare.•Fish bone perforation of the GI is rarely diagnosed preoperatively and has a wide spectrum of clinical presentations.•Appropriate imagery techniques and a complete interrogatory will lead to the correct diagnosis.•Delay in diagnosis and treatment can be associated with significant morbidity and mortality.