Imoto Akira, Nagata Yuki, Shinohara Yoshinori, Miyazaki Hirota, Fukumoto Masanobu, Kitae Hidehiro, Asada Masateru, Noda Masafumi, Okada Kaoru, Asai Akira, Higuchi Kazuhide, Nishikawa Hiroki
Department of Internal Medicine, Aoyama Hospital, Fujiidera, Japan.
Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki, Japan.
Case Rep Gastroenterol. 2024 Sep 23;18(1):431-438. doi: 10.1159/000541081. eCollection 2024 Jan-Dec.
Fishbone (FB) ingestion is a rare cause of gastrointestinal perforation. Herein, we report a case of FB-induced colonic perforation, in which the presence of a penile colonic carcinoma may have contributed to the development of the perforation.
An 83-year-old man was admitted to our hospital with severe abdominal pain during bowel movement. Computed tomography (CT) yielded a diagnosis of sigmoid colonic perforation due to FB and secondary peritonitis. Preoperative endoscopic examination suggested that the perforation was associated with a stalked colon tumor in the vicinity. After undergoing low anterior resection and sigmoid colostomy, the patient is currently doing well.
The incidence of FB-induced colorectal-cancer-related perforation is expected to increase in the future owing to an aging society, the increase in the rates of colorectal cancer, and increase in fish consumption. This rare case suggests that preoperative examinations are important and that even relatively small polyps can contribute to gastrointestinal perforation caused by FBs. Older individuals should exercise caution during fish ingestion.
鱼骨(FB)摄入是胃肠道穿孔的罕见原因。在此,我们报告一例FB导致的结肠穿孔病例,其中阴茎结肠癌的存在可能促成了穿孔的发生。
一名83岁男性因排便时剧烈腹痛入院。计算机断层扫描(CT)诊断为FB导致的乙状结肠穿孔及继发性腹膜炎。术前内镜检查提示穿孔与附近带蒂结肠肿瘤有关。患者接受低位前切除和乙状结肠造口术后,目前情况良好。
由于社会老龄化、结直肠癌发病率上升以及鱼类消费增加,预计未来FB导致的与结直肠癌相关的穿孔发生率将会增加。这个罕见病例表明术前检查很重要,而且即使是相对较小的息肉也可能导致FB引起的胃肠道穿孔。老年人在食用鱼类时应谨慎。