Rare laparoscopic removal of fish-bone conducted at United Hospital

A diagnosed stomach cancer patient was saved from major stomach resection surgery as the correct diagnosis and surgery as laparoscopic removal of stuck fish-bone was done by Prof Anisur Rahman, Senior Consultant GI Surgeon at United Hospital.

A lady aged 52 years was being treated for unexplained anemia in a local hospital in a city outside Dhaka, said a press release. Very recently she developed pain in her abdomen for the previous few days.

The CT scan done locally a week back showed thickened stomach wall at the antral region i.e. from where the food exits from the stomach. Endoscopy also reported narrowing of the antrum i.e. the exit route from the stomach has got narrowed, endoscopic biopsy showing inflammation of stomach lining.

She was diagnosed with Stomach Cancer and for that she was advised to have a surgery to remove part of her cancerous stomach i.e. partial gastrectomy.

The patient wanted to do the surgery at United Hospital and travelled from her city to Dhaka to get admitted under Prof Dr Anisur Rahman, Senior General Surgery Consultant.

On examination the patient was found to be anemic with 7% blood hemoglobin, with mild fever of 100 degree Fahrenheit having moderate tenderness in upper abdomen.

Prof Anisur Rahman decided to repeat the CT scan and the endoscopy. And it revealed an image which according to his observation was that the patient had a long fish bone perforating the lower end of stomach (antrum) and also penetrating the liver causing abscess with accumulation of pus making patient's abdomen very tender with raised total count of blood.

Prof Rahman drained the liver abscess and removed the fish bone through key-hole laparoscopy surgery. He found the stomach to be plastered to the undersurface of the liver and the surrounding area showed fibrinous adhesion and fluid.

He separated the stomach by blunt dissection and large volume of pus mixed with dark partially clotted blood gushed out. The fishbone could be seen sticking from the gastric wall.

The pus was aspirated, fish bone removed, and the abscess cavity washed with normal saline through a tube; the inflammatory exudate was aspirated out after irrigation with normal saline.

After the surgery Prof Anisur Rahman expressed his satisfaction saying, "feeling rather satisfied that a diagnosis of stomach cancer has been resolved with drainage of liver abscess caused by stuck fish-bone"