Published online Mar 6, 2023. doi: 10.12998/wjcc.v11.i7.1650
Peer-review started: December 7, 2022
First decision: January 19, 2023
Revised: January 27, 2023
Accepted: February 15, 2023
Article in press: February 15, 2023
Published online: March 6, 2023
Processing time: 85 Days and 6.8 Hours
Patients with foreign bodies in the digestive tract are often encountered, but complete penetration of a foreign body through the gastrointestinal tract is rare, and the choice of imaging method is very important. Improper selection may lead to missed diagnosis or misdiagnosis.
An 81-year-old man was diagnosed as having a liver malignancy after he took magnetic resonance imaging and positron emission tomography/computed tomography (CT) examinations. The pain improved after the patient accepted gamma knife treatment. However, he was admitted to our hospital 2 mo later due to fever and abdominal pain. This time, he received a contrast-enhanced CT scan, which showed fish-boon-like foreign bodies in the liver with peripheral abscess formation, then he went to the superior hospital for surgery. It lasted for more than 2 mo from the onset of the disease to the surgical treatment. A 43-year-old woman with a 1 mo history of a perianal mass with no obvious pain or discomfort was diagnosed as having an anal fistula with the formation of a local small abscess cavity. Clinical perianal abscess surgery was performed, and fish bone foreign body was found in perianal soft tissue during the operation.
For patients with pain symptoms, the possibility of foreign body perforation should be considered. Magnetic resonance imaging is not comprehensive and that a plain computed tomography scan of the pain area is necessary.
Core Tip: We report two cases of digestive tract foreign body perforation, with one foreign body located in the liver and the other foreign body located around the anus, both of which were misdiagnosed by magnetic resonance examination. We hope that through our report, there will be more diagnostic ideas for similar problems in clinics in the future.