Foreign body ingestion is a very common reason for access to the Emergency Department and in most cases, it doesn't cause symptoms; in case of fishbones, intestinal perforation is rare but possible. In this report, besides the typical picture of bowel perforation, we found atypical symptoms due to the specific location. We present a case of a 70-year-old man who presented to the Emergency Department complaining abdominal pain and several syncopes; a CT scan of the abdomen revealed the presence of a foreign body in the pyloric area, which was removed by surgical intervention and resulted to be a fishbone. Both abdominal and neurological symptoms disappeared. Results and conclusion We suppose that the specific location of fishbone, in the area when the pyloric branches of left vagus nerve run, can explain both the abdominal symptoms and the vasovagal syncope, through a sympathetic inhibition mechanism: Emergency physicians and emergency surgeons must be aware when dealing with symptoms apparently discordant that could be attributable to one common factor.
Found the needle in the haystack! The case of a fishbone causing vasovagal syncopes and abdominal pain: a case report / Sermoneta, Daniel; Favi, Francesco; Salvadori, Carlo; Coniglio, Marco; Mari, Francesco Saverio. - In: INTERNATIONAL JOURNAL OF CRITICAL CARE AND EMERGENCY MEDICINE. - ISSN 2474-3674. - 4:2(2018), pp. 1-3. [10.23937/2474-3674/1510038]
Found the needle in the haystack! The case of a fishbone causing vasovagal syncopes and abdominal pain: a case report
Daniel, Sermoneta;Francesco, Favi;Carlo, Salvadori;Francesco Saverio, Mari
2018
Abstract
Foreign body ingestion is a very common reason for access to the Emergency Department and in most cases, it doesn't cause symptoms; in case of fishbones, intestinal perforation is rare but possible. In this report, besides the typical picture of bowel perforation, we found atypical symptoms due to the specific location. We present a case of a 70-year-old man who presented to the Emergency Department complaining abdominal pain and several syncopes; a CT scan of the abdomen revealed the presence of a foreign body in the pyloric area, which was removed by surgical intervention and resulted to be a fishbone. Both abdominal and neurological symptoms disappeared. Results and conclusion We suppose that the specific location of fishbone, in the area when the pyloric branches of left vagus nerve run, can explain both the abdominal symptoms and the vasovagal syncope, through a sympathetic inhibition mechanism: Emergency physicians and emergency surgeons must be aware when dealing with symptoms apparently discordant that could be attributable to one common factor.File | Dimensione | Formato | |
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