A Case Report of Perianal Abscess due to Ingested Fish Bone

概要

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A 71-year-old male was admitted to our clinic because of anal pain with incontinence on walking. He had eaten boiled sea bream one week before being admitted to our office with a five-day history of anal pain. His pain had started just after defecation and was aggravated by sitting and defecation thereafter. On digital rectal examination after local anesthesia, a fish bone was found: it measured 2.2×2.0 cm, and was palpable within the primary opening of the anal abscess cavity at the 1 o'clock position. He was diagnosed as having a perianal abscess due to a penetrated fish bone, and loop drainage and removal of the fish bone were performed. A loop drainage, composed of a narrow Penrose drain, was inserted and tied under regional anesthesia. Two hours after the operation, he was discharged from our clinic because his general condition was stable. Two weeks after the operation, the drain was exchanged for a rubber band without any anesthesia at our clinic, and was then tightened at two-week intervals until cutting was complete. He was followed up at our clinic until the wound had healed. He had no recurrence, with total conservation of anal continence, and was satisfied with the treatment. In conclusion, a loop drainage seems to be safe and effective for office treatment of perianal abscess due to ingested fish bone.