Laparosc Endosc Surg Sci . 2022; 29(1): 52-55 | DOI: 10.14744/less.2021.49389

Ileal perforation secondary to fish bone ingestion mimicking acute appendicitis

Mehmet Akif Aydýn¹, Nusabe Kaya², Farid Aghazada³, Khoshbo Noor^3
1Department of General Surgery, Altinbas University Faculty of Medicine Medical Park Bahcelievler Hospital, Istanbul, Turkey
²Medical Park Bahcelievler Hospital radiology clinic, Istanbul, Turkey
³School of Medicine, Altinbas University, Istanbul, Turkey

Foreign body (FB) ingestion is commonly encountered in a clinical setting. However, the presence of perforation resulting from the ingested FB is an occurrence that is rarely seen. The most common cause of FB perforation is known to be fish bone. It’s important to emphasize that the complications resulting from fish bone ingestion may lead to findings such as acute abdomen signs that can also be interpreted as other medical conditions, including acute appendicitis, acute diverticulitis, or peptic ulcer perforation. Thus, the differential diagnosis should be made, and the patient should be managed accordingly. In cases where the patient presents with acute abdomen signs but there are no clinical findings that may explain the initial diagnosis of the patient, a complete surgical exploration should be performed. We present a 50-year-old male patient who presented to the emergency room with complaints of abdominal pain. Following a thorough clinical examination and blood investigations, it was revealed that he had acute abdomen signs and a high level of C-reactive protein (CRP) and because of these findings, exploratory laparoscopy was decided to be performed. Intraoperatively, the FB was removed, and the site of perforation was repaired with primary closure.

Keywords: foreign body, fish bone, acute appendicitis, ileum perforation, exploratory laparoscopy

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Balýk kýlçýðýna baðlý apandisiti taklit eden ileum perforasyonu

Mehmet Akif Aydýn¹, Nusabe Kaya², Farid Aghazada³, Khoshbo Noor^3
1Altýnbaþ üniversitesi týp fakültesi genel cerrahi ana bilim dalý,Ýstanbul
²Bahçelievler medicalpark Hastanesi Radyoloji Kliniði, Ýstanbul
³Altýnbaþ üniversitesi týp fakültesi,Ýstanbul,Türkiye

Yabancý cisim (YC) yutulmasý, klinik olarak yaygýn karþýlaþýlan bir durumdur. Ancak yutulan yabancý cisme baðlý perforasyon varlýðý nadiren görülen bir durumdur. Yabancý cisme baðlý perforasyonunun en yaygýn nedeninin balýk kýlçýðý olduðu bilinmektedir. Kýlçýk yutulmasýna baðlý komplikasyonlarý akut apandisit, akut divertikülit veya peptik ülser perforasyonu gibi akut karýn belirtileri gösterebilir. Bu nedenle ayýrýcý taný yapýlmalý ve hasta buna göre yönetilmelidir. Hastanýn akut karýn bulgularý ile baþvurduðu ancak ilk tanýsýný açýklayabilecek klinik bulgularýn olmadýðý durumlarda tam cerrahi eksplorasyon yapýlmalýdýr. Bu olgu sunumunda acil servise karýn aðrýsý þikayeti ile baþvuran 50 yaþýnda erkek hastayý sunmak istedik. Kapsamlý bir klinik muayene ve kan tetkikleri sonucunda akut karýn bulgularýnýn olduðu ve C-reaktif protein (CRP) düzeyinin yüksek olduðu anlaþýldý ve bu bulgular nedeniyle eksploratif laparoskopi yapýlmasýna karar verildi. Ýntraoperatif olarak YC çýkarýldý ve perforasyon bölgesine primer kapama uygulandý.

Anahtar Kelimeler: yabancý cisim, balýk kýlçýðý, akut apandisit, ileum perforasyonu, eksploratuvar laparoskopi

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