Korean J Gastroenterol.  2011 Oct;58(4):212-216. 10.4166/kjg.2011.58.4.212.

Retroperitoneal Hemorrhage after Endoscopic Removal of a Fish Bone Stuck in the Duodenum of a Patient Receiving Hemodialysis

• Lee MK
• Hyun YK
• Kim YJ
• Yoon SY
• Joh JH
• Lee JI
• Cho JH
• Kim HM

• KMID: 1718430
• DOI: http://doi.org/10.4166/kjg.2011.58.4.212

Abstract

Fish bones are often ingested accidently. Most of them passes out through the gastrointestinal tract safely, but serious complications, such as perforation, abscess, obstruction, and bleeding in the gastrointestinal tract, can occur. An ingested fish bone can be easily removed by endoscopy, and surgery is rarely required. However, there may be complications related to the endoscopic procedure including mucosal laceration, bleeding, fever, and perforation. Here, we report a case of retroperitoneal hemorrhage developed after endoscopic removal of a fish bone stuck in the duodenal wall, and then resolved spontaneously by conservative care.

Keyword

Retroperitoneal space; Hemorrhage; Foreign bodies; Endoscopy

MeSH Terms

*Duodenum/injuries
*Endoscopy, Gastrointestinal
Foreign Bodies/*complications/therapy
Gastrointestinal Hemorrhage/etiology
Humans
Male
Middle Aged
*Renal Dialysis
Tomography, X-Ray Computed

Figure

• 

  Fig. 1. Plain abdominal X-ray. It revealed severe kyphosis (A) and no other abnormalities in the abdomen on admission (B).

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  Fig. 2. Endoscopic findings. A fish bone was stuck in the duodenal wall (A, B). During endoscopy, the fish bone was removed by biopsy forceps (C). The fish bone was measured about 3 cm-in length (D).

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  Fig. 3. Abdomen CT findings. One day after removing the fish bone, it showed retroperitoneal hemorrhage (white star). (A) Hemorrhage was noted around the second portion of the duodenum. (B) The hemorrhage extended to the retroperitoneal space of the pelvis. (C, D) A huge retroperitoneal hemorrhage was seen in the coronal view.

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  Fig. 4. Follow up abdomen CT findings. Twenty days after removing the fish bone, the retroperitoneal hemorrhage had resolved around the duodenum (A) and in the pelvis (B).

Reference

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