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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.


Figure 1
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  		Fig. 1 —32-year-old man (patient 2) with duodenal perforation. CT scan shows fish bone (arrow) as a linear radiopaque density within an abscess cavity in the lesser sac. (Reprinted from [9] with kind permission from Springer Science and Business Media)

 

Figure 2
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  		Fig. 2 —72-year-old woman (patient 5) with perforation of transverse colon. CT scan shows intraabdominal abscess abutting abdominal wall with 2.5-cm circumlinear density (arrow) within it.

 

Figure 3
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  		Fig. 3 —45-year-old man (patient 3) with antral perforation. Repeat unenhanced CT scan shows 2.7-cm linear density (arrow) penetrating gastric wall with adjacent areas of inflammation.

 

Figure 4
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  		Fig. 4 —60-year-old woman (patient 6) with gastric perforation. CT scan shows 2.9 x 1.7 cm ill-defined low-density mass in body of pancreas abutting thickened posterior wall of stomach. Linear radiopaque structure (arrow) traverses mass. Mass was thought to be locally advanced pancreatic cystadenocarcinoma or ductal carcinoma with cystic degeneration with blood vessel traversing it. (Reprinted from [10] with kind permission from Springer Science and Business Media)

 

Figure 5
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  		Fig. 5 —44-year-old man (patient 7) with jejunal perforation. CT scan shows short loop of thickened and dilated small bowel suggestive of inflammation with offending fish bone (arrow). Bone was missed initially.

 

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