Published online Feb 16, 2022. doi: 10.12998/wjcc.v10.i5.1586
Peer-review started: August 13, 2021
First decision: October 22, 2021
Revised: October 30, 2021
Accepted: December 31, 2021
Article in press: December 31, 2021
Published online: February 16, 2022
Processing time: 181 Days and 14.6 Hours
Submucosal protuberance caused by fish bone insertion into the digestive tract has rarely been reported. These cases usually include patients with clear signs such as a history of fish intake, pain, and dysphagia, as well as positive findings on endoscopy and imaging. Here, we report a case of a fish bone hidden in the submucosal protuberance of the gastric antrum during endoscopic submucosal dissection without preoperative obvious positive signs.
A 58-year-old woman presented with epigastric pain for the past 20 d and a submucosal protuberance. Abdominal computed tomography and endoscopic ultrasonography did not indicate the presence of a fish bone. We assumed the cause to be an ordinary submucosal eminence and performed an endoscopic submucosal dissection to confirm its essence. During the operation, a fish bone approximately 20 mm in length was found incidentally.
Our report could potentially prevent the oversight of embedded fish bones and associated adverse effects in patients with similar presentation.
Core Tip: Ingested fish bones appear as high-density shadows and hyperechoic structures on computed tomography and endoscopic ultrasonography scans. Patients typically present with symptoms or positive findings on ancillary examinations. Herein, we present a case of a fish bone hidden in the submucosal protuberance of the gastric antrum without the usual positive signs. In this rare case, we identified the reasons for the fish bone being overlooked in the diagnosis process. This report could potentially prevent the future oversight of embedded fish bones and associated adverse effects.