Peritoneal dialysis patient having fish bone-induced colon perforation

Excerpt

A 62-year-old man receiving peritoneal dialysis (PD) visited our hospital because of fever, periumbilical dull pain, and cloudy PD effluent. His physical examination showed tenderness and muscular defense throughout the entire abdomen. Blood examination indicated leukocytosis and an increase in CRP. A large number of neutrophils were found in his PD fluid. These findings were sufficient for the diagnosis of peritonitis. Before starting antibiotic therapy, abdominal computed tomography (CT) was performed. Surprisingly, a linear fish bone that extended transmurally through the sigmoid colon wall was detected (Fig. 1). Immediately it was removed surgically, and the perforated colon was covered. …