Small bowel perforation caused by ingested fish bone: Diagnosis and management by laparoscopy

Summary Bowel perforation caused by a foreign body is an uncommon etiology of acute abdomen. An accurate diagnosis of the level and cause of the perforation is essential for therapeutic planning, but it is usually challenging. This report presents the case of a 66-year-old man who underwent a diagnostic laparoscopy for suspicion of hollow viscus perforation. We used the underwater intestinal milking method to detect the perforation caused by fish bone, which was intracorporeally repaired using interrupted sutures. Because of the lack of tactile sensation, a laparoscopic diagnosis of acute abdomen is completely dependent on visual assessment. Therefore, making the correct decision requires expertise and sufficient skill in laparoscopic surgery. The experience reported herein is feasible for the diagnosis and management of small bowel perforation caused by a foreign body.