A Case of Thoracolumbar Subfascial Abscess Caused by Migration of an Accidentally Swallowed Fish Bone

Abstract

An 83-year-old man presenting with fever and swelling of the right thoracolumbar region was admitted to the department of internal medicine in our hospital. Intramuscular abscess was suspected by a computed tomography (CT) scan and he was referred to our department of surgery. After an aspiration drainage and administration of antibacterial agents, his symptoms improved but recurred 3 weeks later. We performed percutaneous drainage of the abscess. As a fish bone in the abscess was demonstrated retrospectively on CT, we removed it under spinal anesthesia. His postoperative course was uneventful. A colonoscopic examination revealed multiple diverticula in the ascending colon and localized edematous mucosa with an inflammatory polyp like lesion in the hepatic flexure. We considered that the ingested fish bone had passed through the colonic wall, migrated to the retroperitoneum further under right thoracolumbar fascia, and developed abscess. There are some cases in which a fish bone penetrated the gastrointestinal tract, but it is rare that a fish bone reached the dorsal muscle.