A Case of Retroperitoneal Abscess Caused by Duodenal Penetration by an Ingested Fish Bone

Abstract

A case of retroperitoneal abscess caused by duodenal penetration by an ingested fish bone is reported. This case is only the third to be reported in Japan. A 75-year-old woman was admitted to the hospital because of an upper abdominal pain. An abdominal CT scan revealed a small amount of free air at the back of the pancreas head. An esophagogastroduodenoscopy (EGD) revealed the penetration of the second portion of the duodenum by a fish bone, which was 32 mm in length. The fish bone was removed during the EGD. The administration of antibiotics for five days did not improve her symptoms, and the formation of an abscess at the back of the pancreas head was revealed. A laparotomy was subsequently performed. Only three cases, including the present case, of a retroperitoneal abscess caused by duodenal penetration by an ingested fish bone have been reported. These rare cases are reviewed.