A case of endoscopic resection of a fish bone penetrating the gastric wall

Abstract

An 84-year-old man presented to our hospital, complaining of right lower abdominal pain after left chest pain the day before. Blood analysis revealed a leucocyte count of 17,030/mm³ and C-reactive protein (CRP) of 0.32mg/dl. The patient revisited due to persistence of the symptom, and at this time blood analysis revealed a leucocyte count of 15,270/mm3 and CRP of 14.04 mg/dl. The patient was admitted to our hospital and made a rapid improvement after treatment with antibiotics. However, the symptom was still present one day later and a partial peritonitis was suspected. This was confirmed using abdominal CT, which also identified a linear high-density structure penetrating the gastric wall. Emergency gastrointestinal endoscopic examination revealed a fish bone penetrating into the anterior wall of the antrum. After the penetrating bone was removed with grasping forceps, clips were applied at the site of bone removal. The removed bone measured 43 mm in length. 7 days later, the patient had recovered and started to eat.