A Case of Reccurence of Intraperitoneal Abscess for Fish Bone Ileum Perforation 4 Months after Previous Drainage

Abstract

A 76-year-old man was brought into our hospital by an ambulance for abdominal pain and vomiting. Computed tomography (CT) of the abdomen revealed intestinal obstruction by an intraabdominal abscess, and his symptoms were relieved by CT guided abscess drainage. CT performed later suggested intraabdominal abscess by intestinal perforation for a fish bone. He presented to our hospital with abdominal pain and fever 4 months later. We diagnosed the case as recurrence of abdominal abscess by the remained fish bone. We performed laparoscopic surgery for extracting the fish bone and for resecting the perforated intestine. He has been passed without recurrence until now. When we select conservative therapy for intestinal perforation by a fish bone, we have a risk of recurrence by the remained fish bone, therefore we should extract the fish bone as a rule. In this case, we were able to find the small fish bone and perform an operation minutely even on the operative field with severe inflammation by employing laparoscopic surgery.