DISCUSSIONS
Fishbone perforation is rarely seen, especially in children. Although
most foreign objects can be excreted within a week of entering the
gastrointestinal tract (1, 5), 1% of patients may still suffer from
intestinal perforation if these fishbones were long or sharp. Moreover,
it could be complicated to make a precise diagnosis because patients or
their families cannot make sure what foreign object they ate in their
meals. So, these cases are often
misdiagnosed with acute appendicitis.
Depending on the hole’s location, patients may have various clinical
symptoms, including constipation, abdominal pain, and anal pain. A study
reported that 95% of patients presented with abdominal pain, which is
the most crucial symptom, 81% having a fever, and 39% having local
peritonitis (2). In most cases of intestinal perforation caused by a
foreign object, the foreign agent is a fishbone with a pointed shape. In
some countries or regions that prefer eating fish, gastric perforation
or other complications caused by fishbone are very common (6). While
fish bones may induce intestinal perforation in any section of the
intestine, it is more commonly seen in areas of physiological stenosis
or intestinal transitions such as the ileum or rectosigmoid junction
(7). In a study, the probability of ileal perforation was 83%. (8). In
another report, the perforation of the end of the ileum was 38.6%, but
the jejunum rate was lower, just 14.3% (5).