Nihon Fukubu Kyukyu Igakkai Zasshi (Journal of Abdominal Emergency Medicine)
Online ISSN : 1882-4781
Print ISSN : 1340-2242
ISSN-L : 1340-2242
A Case of Peritonitis due to Perforation of the Appendix by a Fish Bone
Mayumi KawamataHaruki KurosawaAkimitsu YamadaMichitaka SuzukiChihiro SaitouKazuhiro ShimadaKahoko NakazawaHarumi YamamotoRyusei MatsuyamaMitsutaka SugitaYohei HamaguchiHidenobu MasuiTadao FukushimaMasatoshi MogakiKaoru NagahoriYukio Tsuura
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2008 Volume 28 Issue 1 Pages 97-100

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Abstract
A 49-year-old man was referred to our hospital because with severe hypogastric pain and rebound tenderness on his lower abdomen, so he was admitted to our department. The laboratory data showed a high level of CRP (16.19mg⁄dl). An abdominal CT scan revealed an abscess including a linear high density area close to the ileocecal area. His recent history included swallowing a fish bone when eating a sea bream 7 days previously. Based on the CT imaging and clinical history, he was diagnosed as having perforation of the intestine due to a fish bone. An emergency operation was performed and a fish bone was found in the abscess adjacent to the ileocecal lesion. A perforation, presumably caused by the fishbone, was located at the distal end of the appendix. Cases with perforations of the appendix due to a fish bone have been very rare. In our case we could diagnose it preoperatively except for the actual site of perforation. Some previously reported cases had been diagnosed as malignant tumors with the result that excessive surgery was performed. In order to diagnose these cases accurately it is important to pay close attention to the clinical history and to find a linear high density area in the CT scan.
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© 2008 Japanese Society for Abdominal Emergency Medicine
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