Case Report
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Mar 26, 2019; 7(6): 805-808
Published online Mar 26, 2019. doi: 10.12998/wjcc.v7.i6.805
Unexplained abdominal pain due to a fish bone penetrating the gastric antrum and migrating into the neck of the pancreas: A case report
Rui Xie, Bi-Guang Tuo, Hui-Chao Wu
Rui Xie, Bi-Guang Tuo, Hui-Chao Wu, Department of Gastroenterology, Affiliated Hospital to Zunyi Medical College, Zunyi 563003, Guizhou Province, China
Author contributions: Tuo BG and Wu HC are the co-corresponding authors; Xie R managed the patient and collected the data; Tuo BG and Wu HC were responsible for case report design and writing.
Informed consent statement: Written informed consent was obtained.
Conflict-of-interest statement: The authors declare no conflicts 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: Hui-Chao Wu, PhD, Full Professor, Department of Gastroenterology, Affiliated Hospital to Zunyi Medical College, 149 Dalian Road, Zunyi 563003, Guizhou Province, China. wuhuichao_gzzy@aliyun.com
Telephone: +86-851-28609206
Received: December 19, 2018
Peer-review started: December 19, 2018
First decision: January 6, 2019
Revised: January 21, 2019
Accepted: February 26, 2019
Article in press: February 26, 2019
Published online: March 26, 2019
Processing time: 97 Days and 15.5 Hours
Abstract
BACKGROUND

Ingestion of foreign bodies results in gastrointestinal perforation in approximately 1% of patients, and fish bones are the objects that most commonly lead to bowel perforation. When it does occur, the terminal ileum is the most common site of perforation, followed by the duodenal C-loop. However, involvement of the pancreas is very rare. Because clinical symptoms are nonspecific and gastrointestinal perforation may present as only odynophagia or abdominal pain, a definite preoperative diagnosis and clinical intervention may be delayed.

CASE SUMMARY

We report the case of a 32-year-old man who presented to our hospital because of abdominal pain that had worsened over 5 d. He had no significant past history except that he had eaten fish 1 wk previously. Upper endoscopy revealed an irregular submucosal tumor on the front wall of the gastric antrum. Endoscopic ultrasonography and computed tomography showed a fish bone penetrating the gastric antrum and migratingin to the neck of the pancreas. The patient underwent laparoscopic surgery and had no complications one week after the operation.

CONCLUSION

A recent history of foreign body ingestion and imaging examinations are helpful for diagnosis of unexplained abdominal pain caused by foreign bodies.

Keywords: Unexplained abdominal pain; Fish bone; Gastrointestinal perforation; Pancreas; Case report

Core tip: Only rare cases of fish bone migration to the pancreas have been described in the literature. We report the case of a 32-year-old man who presented with unexplained abdominal pain due to a fish bone penetrating the gastric antrum and migrating into the neck of the pancreas. Clinical symptoms are nonspecific so that correct diagnosis may be delayed, and imaging examination and endoscopic ultrasonography are reported to be the main diagnostic tools. Laparoscopy is an effective method for identifying and removing the fish bone.