CT highly suspected fish bone-induced gastric perforation, but no foreign body was identified intraoperatively: a report of three cases.

Fish bone ingestion is common, but fish bone-induced gastric perforation is rare. Preoperative computed tomography (CT) may suggest fish bone-related lesions, although no foreign body may be identified intraoperatively in some cases. This report describes three patients with acute epigastric pain following recent fish consumption. CT showed gastric antral wall thickening and linear hyperdense shadows. All patients underwent emergency laparoscopic surgery, with two requiring conversion to open surgery. A fish bone was identified in one case, but no foreign body was identified in the other two cases. All patients underwent perforation repair, irrigation, and drainage, and no postoperative complications occurred. This case series highlights the importance of considering fish bone-induced gastric perforation in patients with acute epigastric pain and a recent history of fish consumption, emphasizing the diagnostic value of preoperative CT.