Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Feb 16, 2022; 10(5): 1586-1591
Published online Feb 16, 2022. doi: 10.12998/wjcc.v10.i5.1586
Submucosal protuberance caused by a fish bone in the absence of preoperative positive signs: A case report
Wei-Wei Du, Tao Huang, Guo-Dong Yang, Jing Zhang, Jing Chen, Ying-Bang Wang
Wei-Wei Du, Department of Gastroenterology, The Third People's Hospital of Chengdu, The Affiliated Hospital of Southwest Jiaotong University, Chengdu, 610000, Sichuan Province, China
Tao Huang, Guo-Dong Yang, Jing Zhang, Ying-Bang Wang, Department of Gastroenterology and Hepatology, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
Jing Chen, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
Author contributions: Huang T was the patient’s endoscopic surgeon; Du WW and Yang GD reviewed the literature and contributed to manuscript drafting; Zhang J and Wang YB collected the data; Chen J analyzed and interpreted the imaging findings; Huang T, Du WW, and Yang GD were responsible for the revision of the manuscript for important intellectual content; all authors issued final approval for the version to be submitted.
Informed consent statement: Informed written consent was obtained from the patient for the publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Tao Huang, MD, Doctor, Department of Gastroenterology and Hepatology, Affiliated Hospital of North Sichuan Medical College, No. 1 Maoyuan South Road, Shunqing District, Nanchong 637000, Sichuan Province, China. 514663870@qq.com
Received: August 13, 2021
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
Abstract
BACKGROUND

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.

CASE SUMMARY

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.

CONCLUSION

Our report could potentially prevent the oversight of embedded fish bones and associated adverse effects in patients with similar presentation.

Keywords: Gastric submucosal protuberance; Endoscopic mucosal dissection; Computed tomography; Endoscopic ultrasonography; Case report

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.