The Health Agenda, Volume 2. Issue 2. April, 2014

Ingestion of gastro-intestinal foreign bodies represents a challenging clinical scenario. Increased morbidity is the price for the delayed diagnosis of complications and timely treatment. We present a case of 40 year old male patient admitted in the emergency room department complaining of a mid-epigastric pain, fullness and fever since one month after heavy bout of alcohol and non vegetarian food. Based on the patient’s history, physical examination and elevated serum amylase levels, a false diagnosis of pancreatitis, was initially adopted. However, a CT scan confirmed the presence of a radio-opaque foreign body and large thick walled collection in the lesser sac and the presence of air. The patient was unaware of the ingestion of the fish bone. At laparotomy, large organized peri-gastric abscess with pus and a fish bone pinned in the anterior gastric wall was identified and successfully removed. The patient had an uneventful post-operative recovery. High level of suspicion is of paramount importance for the timely diagnosis and treatment