Fig. 28
Rupture. Abdominal CT (a, b) of a patient who had ingested a fishbone (arrow). It perforated the duodenal bulb (asterisk) and lodged on the left lobe of the liver. Note the adjacent liver abscess (arrowheads) that formed as a result. CT of another patient (c) shows an endoluminal calcic density structure—fishbone (arrow) at D3, with a small amount of adjacent extraluminal gas (arrowhead) and fat stranding (curved arrow), indicative of retroperitoneal rupture. CT of yet another patient who had underwent ERCP (d) shows a discontinuity of the posterior wall of D3 (arrow) and extensive pneumoretroperitoneum (asterisk)