Published online Jun 14, 2014. doi: 10.3748/wjg.v20.i22.7075
Revised: January 22, 2014
Accepted: March 8, 2014
Published online: June 14, 2014
Fish bones are the most common foreign objects leading to bowel perforation. Most cases are confined to the extraluminal space without penetration of an adjacent organ. However, abscess formation due to the perforation of the rectosigmoid colon by a fish bone can lead to the penetration of the urinary bladder and may subsequently cause the fish bone to migrate into the urinary bladder. In the presented case, a 42-year-old female was admitted for lower abdominal pain. The computed tomography (CT) demonstrated a 5cm pelvic abscess containing a thin and curvilinear foreign body. After conservative management, the patient was discharged. After 1 mo, the subject developed a mechanical ileus. Surgery had to be delayed due to her hyperthyroidism. Migration of the foreign body to the urinary bladder was shown on additional CT. A Yellowish fish bone 3.5 cm in size was removed through intra-operative cystoscopy. The patient was discharged 8 d after the operation without any unexpected event.
Core tip: Fish bones are the most commonly observed objects leading to bowel perforation. In this case report, abscess formation due to perforation of rectosigmoid colon by a fish bone can lead to its migration to the urinary bladder. The operation timing for removal of foreign body should be tactically considered if the vital signs are stable, but we should always keep in mind that delayed complications such as migration of foreign body to adjacent organ could happen.