Ingested Fishbone Causing Pericolic Abscess

A 65-year-old diabetic woman presented to our clinic with a 10-day history of spasmodic lower abdominal pain, which eventually localized to the left iliac fossa. It was associated with low-grade fever for 3 days. Abdominal examination showed localized tenderness, guarding, and increased temperature. A tender, firm, non-mobile mass was palpated in the same region. Laboratory studies revealed leukocytosis with neutrophilia, and x-ray findings were inconclusive. Contrast-enhanced computed tomography (CECT) showed a loculated intraperitoneal hypodense fluid collection in left hemipelvis that displaced the bowel loops medially. The center of fluid collection had a thin, curved foreign body (Figure 1). A lower midline laparotomy was performed. An abscess cavity (8 x 6 cm) was drained, and the foreign body embedded in the cavity, later identified as a fish bone, was removed (Figure 2). No colonic perforation was evident. The abdomen was closed with a drain, and the patient had an uneventful recovery.