Abstract
Foreign body consumption leading to gastrointestinal perforation is uncommon and sometimes ignored; hence, misdiagnosis is likely. Here in, we present a 26-year-old male who contributed to the department of emergency medicine with chronic lower abdominal pain for three months. He provided no information on his past sea food consumption. The findings of laboratory testing and the first imaging examination were normal. Abdominal CT revealed a high-density lesion, presumed to be a foreign body. During surgical exploration, a fish bone was discovered in the terminal portion of the ileum, resulting in many ileal perforations and the creation of an ileo-ileal fistula. Diagnostic laparoscopy followed by exploratory laparotomy, resection of the perforated bowel segment and side-to-side anastomosis was performed. The patient recovered from surgery nicely and was discharged in good health. A precise diagnosis of complications caused by ingestion of fish bones is fairly difficult. Detailed information on the patient's diet and eating habits must thus be obtained. Patients' clinical manifestations are mainly determined by the location of the perforation, typically at the terminal of the ileum and rectal sigmoid colon. CT and diagnostic exploration are the modalities for accurate diagnosis and management.