Case Report
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Feb 27, 2020; 12(2): 77-84
Published online Feb 27, 2020. doi: 10.4240/wjgs.v12.i2.77
Appendicitis-mimicking presentation in fishbone induced microperforation of the distal duodenum: A case report
Daniel Lim, Cheng-Maw Ho
Daniel Lim, Cheng-Maw Ho, Department of Surgery, National Taiwan University Hospital, Taipei 100, Taiwan
Daniel Lim, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh EH16 4TJ, United Kingdom
Daniel Lim, Victoria Hospital Kirkcaldy, NHS Lothian, South-East Scotland Deanery KY2 5AH, United Kingdom
Author contributions: Ho CM analyzed and interpreted the patient data; Lim D was a major contributor in writing the manuscript; all authors read and approved the final manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report.
Conflict-of-interest statement: The authors declare no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE checklist (2016), and the manuscript was prepared and revised according to the CARE checklist (2016).
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Cheng-Maw Ho, MD, PhD, Associate Professor, Doctor, Surgeon, Department of Surgery, National Taiwan University Hospital, No. 7, Chung-Shan South Rd, Taipei 100, Taiwan. miningho@ntu.edu.tw
Received: October 1, 2019
Peer-review started: October 1, 2019
First decision: October 23, 2019
Revised: November 18, 2019
Accepted: December 5, 2019
Article in press: December 5, 2019
Published online: February 27, 2020
Core Tip

Core tip: This case provides clinicians with a unique insight on how a patient with a fishbone induced upper gastrointestinal microperforation can mimic the lower gastrointestinal symptoms commonly seen in acute appendicitis. It highlights the difficulty that the team faced with the diagnosis and management of such pathology and provides clinicians with an alternative differential diagnosis that can be considered in this specific patient group. Additionally, it serves to remind clinicians about the importance of accurate radiological imaging and the potential of observer error (particularly that of the satisfaction-of-search error) that can occur when managing patients with seemingly straightforward presentations.