Dupont David H, Umejiego Louis Maria, Satoskar Savni, Soumya Nfn, Rosa Santana Marcos, Sikka Anshuman, Ayele Nitsuh, Riera Gonzalez Cesar, Bahadur Nivard, Singh Ajit
General Surgery, St. George's University School of Medicine, New York, USA.
General Surgery, American University of the Caribbean School of Medicine, Detroit, USA.
Cureus. 2024 Oct 22;16(10):e72099. doi: 10.7759/cureus.72099. eCollection 2024 Oct.
Foreign body ingestion of fishbones is a very common complaint where most foreign bodies travel safely through the gastrointestinal tract (GIT) without any serious complications. However, its clinical presentation is nonspecific, and its clinical severity can vary widely, thus requiring the use of conservative and or invasive treatment modalities. In this case report, we present a case of a 42-year-old female who reported eating fish two days prior to presenting with upper gastrointestinal tract (GIT) foreign body impaction in addition to a lower GIT micro-perforation secondary to fishbone ingestion, both of which were successfully managed with conservative, nonsurgical treatment modalities. Impaction, perforation, or obstruction of fishbone foreign bodies often occur at GIT angulations or narrowing. Clinical diagnosis of foreign body ingestion requires the use of multiple modalities such as a detailed history, physical exam, radiographic evaluation, and endoscopic evaluation as needed. Treatment depends on multiple factors and can be conservative or surgical in nature. Fishbone foreign body ingestion is a common complaint and rarely leads to severe complications. However, its diagnosis can be difficult without an explicit history highlighting ingestion of fishbones and requires the use of appropriate imaging modalities such as computed tomography (CT) scans. Subsequent management may require conservative or invasive treatment modalities based on the location of the fishbone, and the presence or absence of accompanying complications such as peritoneal signs, sepsis, and radiographic identification of bowel perforation.
鱼骨异物吞食是一种非常常见的病症，大多数异物可安全通过胃肠道（GIT），不会引发任何严重并发症。然而，其临床表现不具有特异性，临床严重程度差异很大，因此需要采用保守和/或侵入性治疗方式。在本病例报告中，我们呈现了一例42岁女性患者，该患者在出现上消化道（GIT）异物嵌顿前两天报告食用过鱼，此外还因鱼骨吞食继发下消化道微小穿孔，这两种情况均通过保守的非手术治疗方式成功处理。鱼骨异物的嵌顿、穿孔或梗阻常发生在胃肠道的拐角处或狭窄部位。异物吞食的临床诊断需要采用多种方法，如详细的病史、体格检查、影像学评估以及必要时的内镜评估。治疗取决于多种因素，本质上可以是保守治疗或手术治疗。鱼骨异物吞食是一种常见病症，很少导致严重并发症。然而，如果没有明确提示鱼骨吞食的病史，其诊断可能会很困难，并且需要使用适当的成像方法，如计算机断层扫描（CT）。后续处理可能需要根据鱼骨的位置以及是否存在伴随并发症，如腹膜征、败血症和肠道穿孔的影像学表现，采用保守或侵入性治疗方式。
