Hóc xương cá dài 3 cm xuyên vào đường mật... tưởng bị ung thư

A 45-year-old patient with persistent right lower abdominal pain, jaundice, and yellowing of the eyes, suspected of having cancer, was unexpectedly found to have a 3 cm long fish bone lodged in his stomach wall and in his bile duct upon admission to the hospital.

Unexpected cancer-like symptoms… caused by a fish bone

On March 26th, according to information from Can Tho Central General Hospital, doctors in the Endoscopy Department performed endoscopic retrograde cholangiopancreatography (ERCP) to remove a fish bone approximately 3 cm long that had penetrated the stomach wall and entered the bile duct of a patient. This is a very rare case of a fish bone lodged in the stomach that migrated, causing complications such as disrupted bile flow, cholangitis, prolonged abdominal pain… and even anxiety in the patient due to suspected cancer.

The fish bone removed from the patient

Photo: D.T

Previously, patient D.N.H.Đ (45 years old, residing in Vinh Thanh commune, Can Tho city) was admitted to the hospital with pain in the epigastric and right lower abdominal areas, accompanied by jaundice and yellowing of the eyes. Mr. D. stated that his abdominal pain had lasted for several months, and despite seeking treatment at various places, it had not improved. More concerning, the patient's symptoms closely resembled those of serious diseases such as liver cancer, bile duct cancer, and gallbladder cancer.

Immediately after admission, the patient was monitored and treated at the General Surgery Department. Through examination and paraclinical tests, doctors noted dilation of the intrahepatic bile ducts, abnormalities in the bile ducts in the hepatic hilum, and stricture of the two hepatic duct branches leading to the common hepatic duct.

Surprisingly, a contrast-enhanced CT scan revealed a foreign object approximately 3 cm long located in the hepatic hilum, suspected to be the cause of the bile duct obstruction.

After consultation, the team decided to perform endoscopic retrograde cholangiopancreatography (ERCP) to investigate and remove the foreign object. Doctors discovered a fish bone penetrating the patient's common hepatic duct from the outside, with a stone lodged above the bone. Immediately afterward, doctors successfully removed the foreign object, a fish bone approximately 3 cm long, under the guidance of a Spyglass endoscope; simultaneously, a stent was placed in the right hepatic branch to relieve the bile duct obstruction. After 2 hours, the patient was safely transferred to the General Surgery Department for monitoring and treatment. Currently, the patient is alert, responsive, and the abdominal pain has significantly improved.

An extremely rare case

Sharing more about this emergency case, Dr. Nguyen Khac Nam, Deputy Head of the General Surgery Department, Can Tho Central General Hospital, said that bone lodged in the throat is a common household accident that can occur at any age. Most foreign objects pass through the digestive tract harmlessly and are expelled in the stool. Meanwhile, perforation of the digestive tract due to swallowed foreign objects is very rare and is most often observed in the ileocecal and sigmoid rectum regions.

However, the fact that the foreign object migrated to the liver, as in patient D.'s case, is extremely rare. This is extremely rare, and very few cases have been reported in medical literature to date.

The team removed the foreign object from the patient.

Photo: D.T

According to Dr. Nam, foreign objects can reach the liver via one of several routes: directly through the abdominal wall, or by moving from the digestive tract. The movement of foreign objects is often asymptomatic or may cause acute abdominal pain. In the above case, the patient may not remember swallowing the foreign object; symptoms can vary from one week to one year, making diagnosis difficult.

Dr. Nam also noted that foreign objects in the digestive tract such as toothpicks, fish bones, or sharp objects that puncture the digestive tract can cause serious complications such as abscesses and peritonitis if not detected and treated promptly. In the case of patient D., the foreign object also caused bile duct obstruction. Without early intervention, there is a risk of bile duct dilation, liver cell damage, and secondary cirrhosis, seriously affecting health and even threatening the patient's life.

Doctors advise people to be cautious about what they eat, especially when consuming foods with small, sharp bones; and to seek medical attention promptly if they experience any unusual symptoms.