A Case of Abdominal Wall Abscess Formation Long after Penetration of a Fish Bone that was Completely Resected Using Xeroradiography

Abstract

The patient was a woman in her 80s who was admitted with a subcutaneous abdominal mass. Examination revealed overlying skin redness, tenderness, warmth and pus discharge from the mass. Blood examination revealed an increase in the acute inflammatory marker levels. Abdominal CT revealed a highly absorptive foreign body measuring 1.7 cm in size in the region of the abdominal wall redness. A review of a CT performed a year earlier also showed the same foreign body in the abdominal cavity. Based on the findings, we made the diagnosis of abdominal wall abscess due to a foreign body penetrating the abdominal wall. The patient’s general condition was good, so that elective foreign body removal surgery was performed after drainage of the abscess and antibiotic treatment. We confirmed the position of the foreign body preoperatively by abdominal ultrasonography. A part of the foreign body could be visually recognized after clearing some adhesions. The foreign body measured 1.0 cm in length, which was shorter than that observed in the preoperative images, which led to the suspicion that a part of the foreign body remained. We excised the surrounding abdominal wall and omentum, and confirmed the residual foreign body by xeroradiography. We report a rare case of an abdominal wall abscess caused by perforation of a fish bone, in which complete removal of the foreign body was possible, without any residual portion, under the guidance of xeroradiography.