Case 21

 A forty-year-old male came to our hospital suffering from an intermittent piecing pain at left upper abdomen. He had no episodes of trouble and fight. He was given a medicine for diabetes mellitus: his stature height 160cm, body weight 80kg, Body mass index (BMI) 31.25. His profession was a chef of Japanese restaurant and had chances of eating a lot of fish. He did not remember to ingest something strange accidentally. He received CT to investigate the cause of the abdominal pain. A foreign body was detected in non-enhanced CT (Fig. 1). Day 11 non-enhanced CT was conducted again under placing a paper incorporated with lead bars arranged such as grids placed on the abdomen to identify the site of the foreign body from the outside of the body. After CT, skin marking with magic was conducted corresponded to the site of the foreign body for laparoscopic removal(Fig. 2). Compared with CT on Day 1 and Day 11, this foreign body was found to be movable. Laboratory test: ALT 46 U/L　ALP　346　U/L fasting blood sugar 175　mg/dL, HbA1c 8.1%

What do you think this foreign body is ?

1. Fish bone

2. Fish hook

3. Fish line

4. Metal needle

5. Calcified parasite

answer

2016.8.31