A Case of Sealed Off Gastric Perforation with Epigastric Collection due to Ingested Fish Bone

Mahadeo Garale, Varsha Kulkarni and Prashant Umare

Department of Surgery, Seth G.S. Medical College, Mumbai, India

^*Correspondance to: Prashant Umare 

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Abstract:

Introduction: Gastric perforation secondary to ingested foreign bodies is rare, with fish bones being a common cause due to their sharp and linear nature. Such perforations may occasionally seal off, leading to localized intra-abdominal collections and atypical clinical presentations. Case Presentation: A 54/M patient presented with mild epigastric pain and localized tenderness without features of generalized peritonitis. Contrast-enhanced computed tomography of the abdomen revealed a linear hyperdense foreign body below left lobe of liver and lesser curvature of the stomach with a localized epigastric collection, suggestive of a sealed-off gastric perforation. Exploratory laparotomy confirmed a sealed perforation with surrounding inflammatory adhesions and an epigastric pus collection which was aspirated and peritoneal lavage was given. The fish bone was retrieved. Postoperatively, the patient was managed with broad-spectrum antibiotics and supportive care. Recovery was uneventful, and the patient was discharged in stable condition. Discussion: This case emphasizes the importance of maintaining a high index of suspicion for foreign body–related perforation in patients presenting with localized abdominal pain and highlights the role of timely imaging and surgical management in preventing morbidity. Conclusion: Sealed-off gastric perforation due to fish bone ingestion is an uncommon clinical entity and may present with localized symptoms. Early imaging, especially computed tomography, is crucial for diagnosis. Prompt surgical intervention ensures favorable outcomes and prevents serious complications

Keywords:

Sealed-off gastric perforation; Fish bone; Epigastric pus

Cite the Article:

Mahadeo G, Varsha K, Prashant U. A Case of Sealed Off Gastric Perforation with Epigastric Collection due to Ingested Fish Bone. Ann Clin Case Rep. 2026; 11: 2839..