Goyal Pradeep, Gupta Sonali, Sapire Joshua
Department of Radiology, St. Vincent's Medical Center, Bridgeport, Connecticut; The Frank H. Netter MD School of Medicine at Quinnipiac University, North Haven, Connecticut.
The Frank H. Netter MD School of Medicine at Quinnipiac University, North Haven, Connecticut; Department of Medicine, St. Vincent's Medical Center, Bridgeport, Connecticut.
J Emerg Med. 2019 Sep;57(3):e95-e97. doi: 10.1016/j.jemermed.2019.06.013. Epub 2019 Aug 1.
Gastrointestinal complications secondary to fish bone ingestion are rare, however important to recognize in timely manner to prevent morbidity and mortality. Diagnosis is often challenging in setting of non-specific and variable symptoms and lack of history of fish bone ingestion. Diagnostic imaging particularly computed tomography is crucial for diagnosis. However, emphasis should be given on identifying underlying cause of abdominal complications because fish bone is often missed unless specifically looked for. Identification of fish bone is essential for extraction of the inciting nidus. Emergency physician should be aware of this entity to identify it and triage the patients in timely manner. We describe here cases of sub-capsular liver abscess and acute cholecystitis caused by fish bone ingestion. The fish bone as a cause of these complication was initially missed in emergency.
鱼骨摄入继发的胃肠道并发症很少见,但及时识别对于预防发病和死亡很重要。在症状非特异性且多变以及缺乏鱼骨摄入史的情况下,诊断往往具有挑战性。诊断性影像学检查,尤其是计算机断层扫描,对诊断至关重要。然而,应着重识别腹部并发症的潜在原因,因为除非专门寻找,鱼骨常常会被漏诊。识别鱼骨对于取出致病病灶至关重要。急诊医生应了解这种情况以便及时识别并对患者进行分诊。我们在此描述鱼骨摄入导致的肝包膜下脓肿和急性胆囊炎病例。鱼骨作为这些并发症的病因在急诊时最初被漏诊。