A “HIDDEN” FISH BONE ALMOST KILLED A 64-YEAR-OLD MAN

Admitted to the emergency department for severe abdominal pain, a 64-year-old man found himself in a dangerous situation caused by a hidden fish bone lodged in his ileum.. 

What seemed to be just an umbilical hernia

On the morning of August 15, 2025, the patient was admitted to the Emergency Department of Nam Sai Gon International General Hospital with abdominal pain accompanied by an unusual bulging mass. Through clinical examination, when pressing on the area around the umbilicus, doctors noted abdominal wall rigidity in the right iliac fossa (iliac fossa guarding), and the patient experienced pain. Combined with the paraclinical results, the doctors determined that the patient had an umbilical hernia with a 25 mm hernia ring, requiring urgent surgery.

However, the patient had multiple chronic underlying conditions, including prostatic hypertrophy and hypertension, which posed several risks during the surgical process. Therefore, the medical team conducted a thorough consultation to develop appropriate management strategies to ensure the safety of the operation.

A “3-in-1” surgery reveals the hidden culprit

At 5:30 p.m. the same day, the surgical team from the Department of General Surgery—led by Dr. Mai Văn Dũng (MMed, Specialist Level I) and Dr. Quách Tuấn Khang—performed an umbilical hernia repair under endotracheal anesthesia. The team successfully dissected and managed the umbilical hernia sac, which measured approximately 4 × 4 cm, and repositioned it back into the abdominal cavity.

To avoid missing any additional injuries, the team continued to explore the right iliac fossa and discovered the “hidden culprit”: a sharp fish bone lodged in the terminal ileum. This foreign object had caused a bowel perforation, triggering an inflammatory reaction that led to the appendix becoming firmly adhered and secondarily inflamed.

The surgeons immediately removed the foreign body and excised the inflamed appendix. All procedures were completed under a single anesthesia session, ensuring maximum safety for the patient while minimizing the risk of fistula formation and recurrent herniation.

All three dangerous conditions—umbilical hernia, ileal foreign body, and appendicitis—were successfully addressed in a single surgery, promptly preventing potentially life-threatening complications for the 64-year-old patient.

Recovery after a challenging surgery

After the operation, the patient was monitored in the Department of General Surgery. Thanks to the dedicated care of the medical and nursing staff, his condition progressed positively; he was able to eat normally and converse comfortably with his family.

Commenting on this case, Dr. Mai Văn Dũng (MMed, Specialist Level I) stated:
“Complications caused by gastrointestinal foreign bodies can be life-threatening if not detected in time. People should be especially cautious when eating, particularly foods containing bones or seeds—chew thoroughly and swallow slowly to avoid foreign bodies. If symptoms such as persistent abdominal pain, localized pain, or an abnormal bulging mass appear, they should seek medical attention immediately for timely examination and treatment.”

Dr. Dũng further emphasized that regular health check-ups play a crucial role in detecting dangerous conditions that may progress silently without the patient’s awareness.

Nam Sai Gon International General Hospital

No. 88, Street No. 8, Trung Son Residential Area, Binh Hung Commune, Ho Chi Minh City.

Hotline: 18006767

info@nih.com.vn

BRC: No. 0312088602, issued on December 14th, 2012 by the Department of Planning and Investment of Ho Chi Minh City. Medical Examination and Treatment License No. 230/BYT-GPHĐ, issued by the Ministry of Health.