DOI: https://doi.org/10.36347/sjmcr.2026.v14i09.014

Pages: 2006-2009

Background: Foreign body ingestion is a common clinical occurrence that is generally benign. However, sharp objects such as fish bones can cause gastrointestinal perforations, representing rare but potentially severe complications that are often challenging to diagnose. Case Presentation: We report the case of a 66-year-old female patient admitted for febrile abdominal pain evolving over 48 hours. An abdominopelvic computed tomography (CT) scan revealed a transmural, hyperdense linear structure within the ileum, associated with locoregional inflammatory signs, highly suggestive of a foreign body perforation. Laparoscopic exploration confirmed a punctate ileal perforation caused by a fish bone, which was successfully managed via extraction and primary simple suture. The postoperative course was unremarkable. Conclusion: Ileal perforation by a fish bone should be included in the differential diagnosis of any atypical acute abdomen. The CT scan plays a pivotal role in establishing the definitive diagnosis. Prompt surgical intervention facilitates a conservative, organ-sparing approach that yields an excellent prognosis.