Mujahid Ullah, Fayaz-ur Rahman, Hazrat Amin.
Fish bone as a cause of sealed intestinal perforation, a rare presentation.
J Med Sci Jan ;27(4):367-9.

Foreign body (FB) ingestion is frequently reported topic in pediatric literature. Spontaneous passage of FB through the gastrointestinal tract is a norm and the complication rate is very low. Nonspecific presentation and lack of obvious history are the main culprit for delayed diagnosis of these conditions. We also came across a patient with sealed intestinal perforation due to fish bone. This patient presented to us with a one week history of generalised pain abdomen, bilious vomiting, high grade fever, abdominal distension and constipation. There was no history of any foreign body ingestion at that time. On examination tenderness was more in the left hypochondrium. Plain radiographs of the abdomen and CT failed to detect any foreign body. However, ultrasound and CT scan of the abdomen showed some mass lesion with a suspicion of intussusceptions. Abdominal exploration and careful dissection of a mass lesion in the left upper quadrant revealed sealed intestinal perforation and a fish bone lying outside the intestinal lumen. Postoperative patient recovered well and discharge on home medication

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