Fish bones are the leading type of gastrointestinal foreign body in Japan, and most require surgical removal. We describe the endoscopic removal of fish bones from the gastrointestinal tracts of two patients.
Case 1 : A 70-year-old man presented with pain in the left lower abdomen. A 3-cm linear, high-density foreign body was identified by CT in the sigmoid colon. A fish bone was removed by colonoscopy.
Case 2 : A 49-year-old woman was referred to our institution with upper abdominal pain. A linear, high-density structure was identified by CT in the proximal jejunum, and a fish bone was removed using single balloon endoscopy. This is the first report of removal of fish bones from the small intestine by balloon assisted endoscopy. We emphasize that clinicians should be aware of the characteristic imaging features of fish bones : they are usually linear and have high density on CT images. Endoscopic removal and laparotomy should be considered as the first and second approaches, respectively, for removing fish bones from the gastrointestinal tract.
