Two cases of gastric penetration by fish bones with differing courses

Most foreign bodies swallowed accidentally are naturally excreted. Gastric penetration by a fish bone is rare due to anatomical and physiological features such as the thick stomach wall, wide lumen and gastric acid. The most common penetration site is the antral region. The clinical course of fish bone penetration of the gastric antrum may differ depending on the direction of penetration. In this report, two cases of gastric perforation by fish bones that followed different courses are presented. One case was treated conservatively with antibiotics alone, and another case was considered for surgery, due to increased hematoma and penetration of the fish bone into the pancreas. However, the patient’s comorbidities were so severe that surgery was not possible, resulting in meticulous follow-up. Diagnostic imaging was important in these cases.