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©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 26, 2025; 13(36): 114956
Published online Dec 26, 2025. doi: 10.12998/wjcc.v13.i36.114956
Published online Dec 26, 2025. doi: 10.12998/wjcc.v13.i36.114956
Beyond biliary causes, fish bone perforation as a rare etiology of recurrent fever in a post-Whipple patient: A case report
Rama Taha, Ghassan Elsayed, Lama Mohamed, Department of Gastroenterology, Mediclinic Middle East Hospital, Abu Dhabi W67, United Arab Emirates
Eyad Gadour, Multiorgan Transplant Centre of Excellence, Liver Transplantation Unit, King Fahad Specialist Hospital, Dammam 32253, Saudi Arabia
Eyad Gadour, Internal Medicine, Faculty of Medicine, Zamzam University College, Khartoum 11113, Sudan
Co-first authors: Rama Taha and Ghassan Elsayed.
Author contributions: Elsayed G and Gadour E contributed to conceptualization, radiological analysis, image interpretation, and manuscript editing; Taha R and Mohamed L contributed to data collection; Gadour E contributed to manuscript writing, and revision; Elsayed G contributed to clinical management, data interpretation; all authors have reviewed and agreed with the final manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Eyad Gadour, CCST, Consultant, FACP, FRCP, Professor, Multiorgan Transplant Centre of Excellence, Liver Transplantation Unit, King Fahad Specialist Hospital, Ammar Bin Thabit Street, Dammam 32253, Saudi Arabia. eyadgadour@doctors.org.uk
Received: October 11, 2025
Revised: October 30, 2025
Accepted: December 11, 2025
Published online: December 26, 2025
Processing time: 84 Days and 0.2 Hours
Revised: October 30, 2025
Accepted: December 11, 2025
Published online: December 26, 2025
Processing time: 84 Days and 0.2 Hours
Core Tip
Core Tip: This case highlights the importance of considering atypical causes like gastrointestinal foreign body perforation in patients with altered postoperative anatomy presenting with recurrent fever and abdominal pain. Despite extensive workup, the cause remained elusive until deep push enteroscopy identified an embedded fish bone in the efferent jejunal limb of a post-Whipple patient. This was only possible after a thorough review of the computed tomography imaging, which showed a subtle linear hyperdensity. This case demonstrates the value of critical image review and advanced endoscopic techniques in diagnosing obscure gastrointestinal pathology in complex post-surgical patients.