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DOI: 10.48087/BJMS.2026.130321
Authors: Dalila REMACHE1, Sana CHABOU2, Salim MAKHLOUFI1
Affiliations: 1-Department of surgery A, University Hospital of Constantine, University of Constantine3, Algeria. 2- Department of Anesthesiology and Intensive Care, EHS Sidi Mabrouk, University of Constantine3, Algeria.
Abstract
Introduction: Intestinal perforations caused by fish bones are an uncommon but recognized cause of digestive tract perforation, often presenting with variable clinical features. Abdominopelvic computed tomography (CT) remains the cornerstone for diagnosis. Case report: We describe the case of a 60-year-old woman admitted with diffuse abdominal pain initially localized to the right iliac fossa, accompanied by vomiting. Plain abdominal radiography revealed pneumoperitoneum, confirmed by CT scan, which demonstrated diffuse, multi-compartmental pneumoperitoneum without intraperitoneal fluid or clinical signs of peritonitis. CT also identified two foreign bodies within the ileum. The surgical procedure consisted of extraction of the fish bones and closure of the perforations. Conclusion: This case highlights an atypical presentation characterized by the coexistence of two fish bones and two ileal perforations, along with diffuse pneumoperitoneum in the absence of clinical peritonitis. It underscores the pivotal role of CT imaging in rapidly identifying unusual scenarios.
Keywords: fish bone, foreign body, perforation, ileum.