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DOI:10.2214/AJR.05.0178
AJR 2006; 187:710-714
© American Roentgen Ray Society

Clinical Observations

CT in the Preoperative Diagnosis of Fish Bone Perforation of the Gastrointestinal Tract

Brian K. P. Goh1, Yu-Meng Tan1,2, Shueh-En Lin3, Pierce K. H. Chow1,2, Foong-Koon Cheah3, London L. P. J. Ooi1,2 and Wai-Keong Wong1,2

1 Department of Surgery, Singapore General Hospital, Outram Road, Singapore 169608.
2 Department of Surgical Oncology, National Cancer Centre, Singapore 169610.
3 Department of Radiology, Singapore General Hospital, Singapore 169608.

OBJECTIVE. Foreign body perforation of the gastrointestinal (GI) tract has diverse clinical manifestations, and the correct preoperative diagnosis is seldom made. We report our experience with the use of CT in the preoperative diagnosis of fish bone perforation of the GI tract in seven patients. To our knowledge, this series is the largest to date addressing the role of CT in the diagnosis of fish bone perforation.

CONCLUSION. Clinical presentation and radiography are unreliable in the preoperative diagnosis of fish bone perforation of the GI tract. This limitation can be overcome with the use of CT, which is accurate in showing the offending fish bone. The accuracy of CT is limited by observer dependence. A high index of suspicion should always be maintained for the correct diagnosis to be made.

Keywords: abdominal imaging • CT • fish bone • foreign body • gastrointestinal radiology • perforation


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