Gastric perforation due to fish bone ingestion presenting as gastric outlet obstruction: a case report

Abstract

Foreign body ingestion is mostly an accidental incident and usually seen in children than in adults. In adults fish bone ingestion is a common occurrence which is generally asymptomatic and passes through gut without any complications. Ingestion of fish bone leading to gut perforations has been reported and includes distal part of the gastrointestinal tract involving ileum, colon and rectum. Gastric perforation is quiet rare due to its thick muscular wall. Here we present a case of a 65 year old female who presented to our hospital with complains of pain abdomen, vomiting and epigastric lump. On thorough investigation a perforation in the posterior wall of stomach was found along with a fish bone inside an inflammatory lump near the pylorus in the lesser sac, with features of gastric outlet obstruction. Initial conservative management resolved the inflammatory lump and then diagnostic laparoscopy followed by open surgery was performed to retrieve the fish bone. Both open and laparoscopic methods have been successful in retrieving these foreign bodies. Careful investigations and high level of suspicion is required for proper diagnosis and treatment for this benign condition.