A 82-year-old man was referred to our hospital for epigastric pain. Computed tomography revealed a linear high-density structure that perforated the stomach and reached near the neck of the gallbladder. A few hours before he felt pain, he had consumed a sea bream. We diagnosed his condition as a fish bone perforation of the stomach. An upper gastrointestinal endoscopic examination revealed that a fish bone had perforated the antrum of the stomach. The bone was extracted using forceps, and the hole was closed with clip. The bone was 35 mm long and 3 mm wide. After placing a nasogastric tube, a proton pump inhibitor and antibiotics were administered. The patient’s clinical symptoms subsequently improved, and the clinical course was uncomplicated. He was discharged 5 days after the endoscopic treatment. Thus, our results reveal that an endoscopic treatment may be an appropriate choice for treating fish bone perforation without peritonitis.
