2020 Volume 40 Issue 3 Pages 491-494
Although the number of studies of conservative therapy for gastrointestinal tract perforation by ingested fish bone is increasing, there are very few reports of long–term follow–up of these patients after conservative therapy. We report three cases of fish bone perforation of the gastrointestinal tract that were initially treated conservatively and followed up for 1 to 4 years. Case 1: An 83–year–old man with upper abdominal pain was diagnosed as having duodenal perforation caused by an ingested fish bone. His symptoms improved with conservative therapy, and he had no recurrence over the subsequent 2 years. Case 2: A 55–year–old man with continuous left–sided abdominal pain was diagnosed as having intestinal perforation caused by a fish bone. His symptoms improved with conservative therapy. However, he returned with abdominal pain 3 years later and underwent surgery for a recurrent intra–abdominal abscess. Subsequently, he remained without evidence of recurrence for 1 year after the surgery. Case 3: A 48–year–old man, in whom a fish bone was identified incidentally in the abdominal cavity on computed tomography. He opted for follow–up without any treatment, and remained asymptomatic for 1 year. Conservative therapy is a treatment option for some patients with perforation or penetration of the digestive tract caused by an ingested fish bone. However, there is the risk of development of abscess formation after a period of several years due to the fish bone remaining within the abdominal cavity. We should explain this risk to the patient and obtain his/her informed consent prior to providing conservative therapy.
