2024 Volume 44 Issue 1 Pages 65-68
A 64-year-old woman presented to another hospital complaining of right lower abdominal pain. Abdominal computed tomography revealed evidence of an acute abdomen secondary to the presence of a swallowed fishbone in the small intestine. The patient was admitted to the hospital for observation without medical intervention, as it was expected that she would pass the fish bone in her stools. Since she failed to be expel the fishbone in the stools by the following day and the abdominal pain persisted, we repeated the abdominal computed tomography; the scan revealed no change in the position of the fishbone. The patient was then transferred to our hospital for surgical treatment. At arrival, physical examination revealed that the patient was in stable general condition and there was no evidence of peritoneal irritation. Nevertheless, we decided to perform emergency open abdominal surgery. Intraoperatively, we identified Meckel’s diverticulum in the area of the fish bone. As the fishbone had penetrated the mucosa of the diverticulum, we resected the portion of the small intestine that included the diverticulum. Fishbone penetration of a Meckel’s diverticulum is a rare occurrence. Even in the absence of signs of peritoneal irritation, as in the current case, these patients often fail to spontaneously expel the swallowed fishbone in the stools, and early surgical intervention is recommended.
