Abstract
A 69-year-old woman was seen at the hospital because of general fatigue, appetite loss, and newly developed fever and cough lasting for two days. As blood examination showed high degree of inflammatory reaction, she was admitted to the hospital. Antibiotics were ineffective for inflammatory reaction and the patient began to complain of abdominal pain when she moved. She was thus referred to our department. On palpation, a tumor was felt at the midline of the upper abdomen, and there was tenderness at the same area. Ultrasonography and CT of the abdomen revealed a 10×8 cm intraperitoneal abscess adjacent to the gastric wall of the upper abdomen and a 2.5-cm diameter linear shadow of hyper absorption in the abscess. Upper gastrointestinal endoscopic study showed large quantities of residual foods in the stomach, but any foreign body, ulcer, or perforated site was obscure. Laparotomy disclosed an abscess covered with the greater omentum which lay between the stomach and the transverse colon. The abscess could be dissected from the transverse colon but it was communicated with the gastric wall, so that removal of the abscess with associated resection of part of the greater curvature of the gastric antrum was performed. The resected specimen was 11×10×6 cm in size and involved a fish bone, extensive abscess, and purulent fluid.
Here we report a case of an intraperitoneal abscess which had been formed by perforation of the stomach due to a fish bone which was incidentally ingested.
