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<p>Fish bones constitute 12–35% of ingested foreign bodies, but gastrointestinal perforation occurs in &lt; 1% of cases. Transmural migration to the gallbladder is exceedingly rare (&lt; 0.1%). A 57-year-old male presented with right upper abdominal pain for 10&#xa0;days, intermittent fever, and weight loss. Endoscopy showed a rounded submucosal lesion near the pylorus suggestive of a gastrointestinal stromal tumor (GIST)-like mass. Contrast-enhanced computed tomography (CECT) revealed a hyperdense, linear foreign body (3&#xa0;cm) perforating the anterior wall of the pylorus, traversing into the gallbladder wall, and causing pericholecystic inflammation with localized hepatic edema. Laboratory findings indicated sepsis. Management and outcome: Laparoscopic removal of the fish bone with cholecystectomy and abscess drainage was performed. The patient recovered uneventfully. This case highlights the importance of correlating dietary history with imaging findings in atypical abdominal presentations. CT remains the gold standard for detecting radiolucent fish bones and their complications, enabling timely intervention and preventing mortality.</p>

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Meal to Malady: Transmural Migration of an Ingested Fishbone From the Pylorus to the Gallbladder Causing Inflammation and Sepsis

  • 期刊论文

  • 发表日期：

    2026年1月29日

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  • Pravallika Palli

摘要

Fish bones constitute 12–35% of ingested foreign bodies, but gastrointestinal perforation occurs in < 1% of cases. Transmural migration to the gallbladder is exceedingly rare (< 0.1%). A 57-year-old male presented with right upper abdominal pain for 10 days, intermittent fever, and weight loss. Endoscopy showed a rounded submucosal lesion near the pylorus suggestive of a gastrointestinal stromal tumor (GIST)-like mass. Contrast-enhanced computed tomography (CECT) revealed a hyperdense, linear foreign body (3 cm) perforating the anterior wall of the pylorus, traversing into the gallbladder wall, and causing pericholecystic inflammation with localized hepatic edema. Laboratory findings indicated sepsis. Management and outcome: Laparoscopic removal of the fish bone with cholecystectomy and abscess drainage was performed. The patient recovered uneventfully. This case highlights the importance of correlating dietary history with imaging findings in atypical abdominal presentations. CT remains the gold standard for detecting radiolucent fish bones and their complications, enabling timely intervention and preventing mortality.