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Ingested Fish Bone: An Unusual Mechanism of Duodenal Perforation and Pancreatic Trauma

Ingestion of gastrointestinal foreign bodies represents a challenging clinical scenario. Increased morbidity is the price for the delayed diagnosis of complications and timely treatment. We present a case of 57-year-old female patient which was admitted in the emergency room department complaining o...

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Autores principales: Symeonidis, Dimitrios, Koukoulis, Georgios, Baloyiannis, Ioannis, Rizos, Apostolos, Mamaloudis, Ioannis, Tepetes, Konstantinos
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi Publishing Corporation 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3420078/
https://www.ncbi.nlm.nih.gov/pubmed/22919520
http://dx.doi.org/10.1155/2012/308510
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author Symeonidis, Dimitrios
Koukoulis, Georgios
Baloyiannis, Ioannis
Rizos, Apostolos
Mamaloudis, Ioannis
Tepetes, Konstantinos
author_facet Symeonidis, Dimitrios
Koukoulis, Georgios
Baloyiannis, Ioannis
Rizos, Apostolos
Mamaloudis, Ioannis
Tepetes, Konstantinos
author_sort Symeonidis, Dimitrios
collection PubMed
description Ingestion of gastrointestinal foreign bodies represents a challenging clinical scenario. Increased morbidity is the price for the delayed diagnosis of complications and timely treatment. We present a case of 57-year-old female patient which was admitted in the emergency room department complaining of a mid-epigastric pain over the last twenty-four hours. Based on the patient's history, physical examination and elevated serum amylase levels, a false diagnosis of pancreatitis, was initially adopted. However, a CT scan confirmed the presence of a radiopaque foreign body in the pancreatic head and the presence of air bubbles outside the intestinal lumen. The patient was unaware of the ingestion of the foreign body. At laparotomy, after an oblique duodenotomy, a fish bone pinned in the pancreatic head after the penetration of the medial aspect of the second portion of the duodenal wall was identified and successfully removed. The patient had an uneventful postoperative recovery. Wide variation in clinical presentation characterizes the complicated fish bone ingestions. The strategically located site of penetration in the visceral wall is responsible for the often extraordinary gastrointestinal tract injury patterns. Increased level of suspicion is of paramount importance for the timely diagnosis and treatment.
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spelling pubmed-34200782012-08-23 Ingested Fish Bone: An Unusual Mechanism of Duodenal Perforation and Pancreatic Trauma Symeonidis, Dimitrios Koukoulis, Georgios Baloyiannis, Ioannis Rizos, Apostolos Mamaloudis, Ioannis Tepetes, Konstantinos Case Rep Gastrointest Med Case Report Ingestion of gastrointestinal foreign bodies represents a challenging clinical scenario. Increased morbidity is the price for the delayed diagnosis of complications and timely treatment. We present a case of 57-year-old female patient which was admitted in the emergency room department complaining of a mid-epigastric pain over the last twenty-four hours. Based on the patient's history, physical examination and elevated serum amylase levels, a false diagnosis of pancreatitis, was initially adopted. However, a CT scan confirmed the presence of a radiopaque foreign body in the pancreatic head and the presence of air bubbles outside the intestinal lumen. The patient was unaware of the ingestion of the foreign body. At laparotomy, after an oblique duodenotomy, a fish bone pinned in the pancreatic head after the penetration of the medial aspect of the second portion of the duodenal wall was identified and successfully removed. The patient had an uneventful postoperative recovery. Wide variation in clinical presentation characterizes the complicated fish bone ingestions. The strategically located site of penetration in the visceral wall is responsible for the often extraordinary gastrointestinal tract injury patterns. Increased level of suspicion is of paramount importance for the timely diagnosis and treatment. Hindawi Publishing Corporation 2012 2012-08-05 /pmc/articles/PMC3420078/ /pubmed/22919520 http://dx.doi.org/10.1155/2012/308510 Text en Copyright © 2012 Dimitrios Symeonidis et al. https://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Symeonidis, Dimitrios
Koukoulis, Georgios
Baloyiannis, Ioannis
Rizos, Apostolos
Mamaloudis, Ioannis
Tepetes, Konstantinos
Ingested Fish Bone: An Unusual Mechanism of Duodenal Perforation and Pancreatic Trauma
title Ingested Fish Bone: An Unusual Mechanism of Duodenal Perforation and Pancreatic Trauma
title_full Ingested Fish Bone: An Unusual Mechanism of Duodenal Perforation and Pancreatic Trauma
title_fullStr Ingested Fish Bone: An Unusual Mechanism of Duodenal Perforation and Pancreatic Trauma
title_full_unstemmed Ingested Fish Bone: An Unusual Mechanism of Duodenal Perforation and Pancreatic Trauma
title_short Ingested Fish Bone: An Unusual Mechanism of Duodenal Perforation and Pancreatic Trauma
title_sort ingested fish bone: an unusual mechanism of duodenal perforation and pancreatic trauma
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3420078/
https://www.ncbi.nlm.nih.gov/pubmed/22919520
http://dx.doi.org/10.1155/2012/308510
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