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Journal of Medical Ultrasonics

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1999 - Vol.26

Vol.26 No.01

Case Report(症例報告)

(0017 - 0022)


A Case of Inflammatory Granuloma in the Ileocecal Region Caused by Penetration by a Fish Bone and Diagnosed by Ultrasonography and Computed Tomography

藤村 二郎1, 真田 泰興1, 鈴木 重道1, 桑田 幸央1, 井上 和彦1, 坂之上 一史1, 香川 幸司1, 菅沢 一子2, 伊原 恵子2, 多久和 小百合2

Jiro FUJIMURA1, Yasuoki SANADA1, Shigemichi SUZUKI1, Yukio KUWATA1, Kazuhiko INOUE1, Kazufumi SAKANOUE1, Koji KAGAWA1, Kazuko SUGESAWA2, Keiko IHARA2, Sayuri TAKUWA2

1松江赤十字病院内科, 2松江赤十字病院検査部腹部超音波検査室

1Department of Internal Medicine, Matsue Red Cross Hospital, 2000 Horo-machi, Matsue-shi, Shimane-ken 690-0886, Japan, 2Division of Abdominal Ultrasound, Matsue Red Cross Hospital, 2000 Horo-machi, Matsue-shi, Shimane-ken 690-0886, Japan

キーワード : Computed tomography, Fish bone, Ultrasonography

Preoperative diagnosis in the perforation or penetration of the digestive tract by an ingested fish bone is very difficult. A case of inflammatory granuloma in the ileocecal region caused by penetration by a fish bone, diagnosed by ultrasonography (US), and computed tomography (CT) is reported here. A 64-year-old man was seen at this institution because of sudden onset of right lower abdominal pain. Tenderness and muscle defense were present on the right lower quadrant of the abdomen. White blood-cell count was 14,100/mm3, and CRP was 21.2 mg/dl. US examination showed a linear hyperechoic region inside a hypoechoic mass. CT showed a well-defined linear high-density fish bone inside a low-density mass (5×3 cm). The diagnosis was inflammatory granuloma caused by penetration by a fish bone, and surgery was performed. The 3.5-cm bone was found near the perforated region of the appendix during surgery. A diagnosis of inflammatory granuloma resulting from penetration to the appendix by a fish bone was made. This case demonstrates that US examination is effective in preoperative diagnosis.