Fish-bone-related jejunal perforation: a rare presentation and literature review

Accidental ingestion of fish bones is common, but gastrointestinal perforation remains an uncommon complication (<1%). We report the case of a 35-year-old man who developed one week of abdominal pain after consuming a seafood meal. Contrast-enhanced computed tomography demonstrated a radiopaque linear structure measuring approximately 3 cm penetrating a jejunal loop into the mesenteric fat, with associated fat stranding. Diagnostic laparoscopy identified a fish bone perforating the jejunum; the foreign body was removed, and the bowel defect was closed primarily. The postoperative recovery was uncomplicated. A literature review from 2014 to 2025 identified ten comparable cases of fish-bone-related small bowel perforation. These cases highlight diagnostic challenges due to non-specific symptoms and variable imaging findings. Prompt CT imaging and early minimally invasive surgical intervention improve outcomes. Fish-bone perforation should remain part of the differential diagnosis in patients with unexplained abdominal pain following seafood ingestion.