Perforation couverte du duodénum par arête de poisson - à propos d’un cas

Stomach and duodenal foreign bodies perforations tend to have a less hazardous clinical casualties than Jejunal and ileum ones. These perforations may heal spontaneously. Our case is about a 45 years old male patient, with no pathological history, admitted to the emergency room with appendicitis symptoms. He was complaining from a pain in the right side of the abdomen since 2 days with nausea and vomiting. Clinical examination revealed a 39°C fever and an acute pain in the right iliac fossa. Laboratory test showed a hyperleukocytosis at 220 let/mm3 and CRP at 50. Abdominal ultra sound was normal. Ct scan showed a radiopaque foreign body; probably fish bone, lodged in the D2 portion of the duodenum, and appeared to have penetrated the bowel wall with air bubbles in contact and infiltrated fat around. The diagnosis of duodenal perforation was made. The patient received an extraction of the foreign body by endoscopy and was put under antibiotic treatment with good clinical outcome.