A CASE OF RETROPERITONEAL ABSCESS DUE TO PENETRATION OF DUODENUM BY AN INGESTED FISH BONE

A case of retroperitoneal abscess due to a penetration of the duodenum by an ingested fish bone, in which emergency operation could saved the patient's life, is reported. This is the second case in Japan. A 65-year-old man was admitted to the hospital because of abdominal pain. There was a history of gastrectomy for gastric ulcer 16 years before. A abdominal plain X-ray photograph and abdominal CT revealed a retroperitoneal abscess due to the penetration of the duodenum by a foreign body. Laparotomy revealed the retroperitoneal abscess and the penetration of the posterior wall of the second portion of duodenum. The foreign body was recognized in the residual stomach by gastrofiberscope during operation and was taken out through gastrostomy. The foreign body was 58 mm in length, which was the longest ingested fish bone ever reported in Japan. In a review of 59 domestic cases of damaged gastrointestinal tract due to a fish bone, it is thought that the damaged portion and type of the lesion are not be able to be predicted by the length of the fish bone ingested by mistake.