Sharp foreign body and ischio-rectal abscess

This article presents a case of rare cause of peri-anal abscess caused by ingested fish bone. A 72 year old gentleman presented with left buttock painful swelling for 1 week associated with fever. Physical examination revealed a peri-anal abscess. During incision and drainage a 3cm fish bone was found inside the abscess cavity, impinging from the rectal wall. He recalled history of fish bone ingestion around one month before admission. Ingestion of sharp object can cause perforation of gastrointestinal tract, not only the upper tract, but even the lower tract and anal canal. High index of suspicion is needed in cases with history of foreign body ingestion presenting with ischio-rectal abscess, to aid diagnosis and prevent injury to the operating surgeon.