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SHARING CLINICAL CASES FROM DOCTORS AT BACH MAI HOSPITAL – VIGES MEMBERS
Swallowing fish bones is sometimes taken lightly, as in most cases fish bones will pass through the digestive tract without causing complications. However, a few cases can have serious consequences such as stomach perforation, liver abscess, peritonitis, and even be life-threatening if not diagnosed and intervened promptly. Below is a typical report at Bach Mai Hospital that clearly demonstrates the danger of this condition.
1. Typical case
The patient was a 58-year-old male who was admitted to the hospital due to right flank pain and persistent fever. Initial clinical examination and imaging revealed a left liver abscess. Despite ultrasound-guided drainage of the abscess and antibiotic treatment, the patient's abdominal pain did not improve. A subsequent abdominal CT scan revealed a radiopaque rod-shaped foreign body penetrating from the stomach to the left liver, accompanied by free air in the abdominal cavity. This was a piece of fish bone approximately 2.5 cm long.
The patient was scheduled for emergency surgery. During the surgery, doctors noted a small hole in the stomach wall in front of the lesser curvature (about 0.5 cm in diameter), with inflammatory adhesions forming around the stomach and an abscess under the left liver capsule. Doctors removed the foreign object, sutured the stomach hole, cleaned the abdominal cavity and placed a drain. Fortunately, the patient recovered positively, eating and drinking normally after 5 days of antibiotic treatment and post-operative care.
2. Causes and dangerous complications
- The sharp shape of fish bones: Fish bones are thin and have sharp tips, which can easily penetrate and puncture soft tissue. When moving down to the stomach, the bones can get stuck, penetrate the stomach wall, and even spread to the liver or nearby organs.
- Easily confused with other digestive diseases: Common symptoms of swallowing fish bones are often abdominal pain, fever, nausea or digestive disorders. These symptoms are easily mistaken for stomach ulcers, gastritis - duodenitis or common infections, causing the patient to be subjective.
- Serious complications: When a fish bone punctures the stomach, bacteria and digestive juices can enter, causing peritonitis. If the bone penetrates deep into the liver, it can lead to liver abscess or sepsis. Without timely intervention, the patient faces the risk of multiple organ failure and septic shock.
3. Prevention and timely treatment
- Be careful with meals: For fish dishes, bones should be removed carefully, especially when preparing for young children and the elderly.
- Early medical check-up: If you suspect you have swallowed a fish bone, or experience unusual sore throat, chest pain, or abdominal pain after a meal, you should go to a medical facility for examination.
- Interventional endoscopy: In many cases, endoscopy helps identify and remove foreign objects before serious complications occur.
- Emergency surgery: When the digestive tract has perforated or inflammation or abscesses have formed, the final solution is usually surgery to remove the foreign object, suture the perforation and treat the infection.
4. Conclusion
Complications from fish bones can be extremely serious, although the incidence is low. The initial signs are often easily confused with other diseases, causing patients to delay treatment. The case of a fish bone piercing the stomach and creating a left liver abscess in the patient above is a warning lesson about the potential dangers in daily meals. Proactively seeking medical attention early when suspecting bone ingestion, and following intervention instructions (endoscopy or surgery) will help significantly reduce risks such as peritonitis, liver abscess, sepsis and even death.
Always be careful with foods containing bones, especially fish, to protect the health of yourself and your family.
