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Abstract
Gastrointestinal perforation is one of the most common causes of acute abdomen presenting to the casualty. However, gastrointestinal perforation due to ingestion of foreign body is rare and is usually encountered in children, psychiatric patients and in alcoholics. Most of the foreign bodies pass through the GI tract without any complications. Only about 1% are known to cause complications such as perforation. Fish or chicken bones, dentures, toy parts, coins, toothpicks are the most commonly encountered foreign bodies. In this report, we present a case of a 60-year-old male who presented to the emergency department with acute abdomen secondary to ingestion of an unusual foreign body that lead to perforation and underwent exploratory laparotomy for removal of the foreign body.
Gastrointestinal perforation is one of the most common causes of acute abdomen presenting to the casualty that needs a timely surgical intervention.[1] Important sites of gastrointestinal perforation are stomach, duodenum, small bowel (jejunum, small intestine), appendix, colon and rectum.
The most common causes of gastrointestinal perforation include peptic ulcer disease, diverticulitis, carcinomas, IBD, ischemia of bowel wall and infrequently foreign bodies.[2]
Foreign body ingestion as seen in children is unintentional and can be deliberate in psychiatric patients.[3] In general, many of these foreign bodies travel through the gastrointestinal tract without causing complications. Only about 1% cases of ingested foreign bodies cause complications such as hollow viscus obstruction and/ or perforation which are usually life threatening and have poorer outcomes if diagnosis is delayed.[4,5] CT is the imaging tool of choice. Such conditions require immediate surgical intervention such as exploratory laparotomy or laparoscopic or endoscopic removal can be attempted in case of stomach or duodenal foreign bodies.
Here in the following case report, we present an atypical case who arrived at the emergency room with acute abdomen following a foreign body consumption and underwent exploratory laparotomy for retrieval of foreign body.
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References
- Borofsky S, Taffel M, Khati N, et al. The emergency room diagnosis of gastrointestinal tract perforation: the role of CT, Emerg. Radiol 2015;22(3):315-27.
- Romano S, Scaglione M, Tortora G, et al. MDCT in blunt intestinal trauma, Eur J Radiol 2006;59(3):359-66.
- Bansod A, Mehsare P, Kolpakwar S, et al. Small bowel perforation secondary to unusual foreign body - a case report. Int Surg J 2016;3(4):2362-4.
- Goh BK, Chow PK, Quah HM, et al. Perforation of the gastrointestinal tract secondary to ingestion of foreign bodies. World J Surg 2006;30:372-7.
- Kuzmich S, Burke CJ, Harvey CJ, et al. Perforation of gastrointestinal tract by poorly conspicuous ingested foreign bodies: radiological diagnosis. Br J Radiol 2015;88(1050):20150086
- Rodríguez-Hermosa JI, Codina-Cazador A, Sirvent JM, et al Surgically treated perforations of the gastrointestinal tract caused by ingested foreign bodies, Colorectal Dis 2008;10(7):701-7.
- Kim SH, Shin SS, Jeong YY, et al. Gastrointestinal tract perforation: MDCT findings according to the perforation sites. Korean J Radiol 2009;10(1):63-70.
- Cianci R, Bianco V, Esposito G, et al. MDCT imaging of gastrointestinal tract perforation due to foreign body ingestion. Imaging of Alimentary Tract Perforation 2015:79-84.
- Kothari K, Friedman B, Grimaldi GM, et al. Nontraumatic large bowel perforation: spectrum of etiologies and CT findings. Abdominal Radiology 2017;42:2597-608.
- Dua, N. Morgan, A. Kichenaradjou, foreign bodies. Int J Oral Maxillofac Surg 2011;40(10):1149.
References
Borofsky S, Taffel M, Khati N, et al. The emergency room diagnosis of gastrointestinal tract perforation: the role of CT, Emerg. Radiol 2015;22(3):315-27.
Romano S, Scaglione M, Tortora G, et al. MDCT in blunt intestinal trauma, Eur J Radiol 2006;59(3):359-66.
Bansod A, Mehsare P, Kolpakwar S, et al. Small bowel perforation secondary to unusual foreign body - a case report. Int Surg J 2016;3(4):2362-4.
Goh BK, Chow PK, Quah HM, et al. Perforation of the gastrointestinal tract secondary to ingestion of foreign bodies. World J Surg 2006;30:372-7.
Kuzmich S, Burke CJ, Harvey CJ, et al. Perforation of gastrointestinal tract by poorly conspicuous ingested foreign bodies: radiological diagnosis. Br J Radiol 2015;88(1050):20150086
Rodríguez-Hermosa JI, Codina-Cazador A, Sirvent JM, et al Surgically treated perforations of the gastrointestinal tract caused by ingested foreign bodies, Colorectal Dis 2008;10(7):701-7.
Kim SH, Shin SS, Jeong YY, et al. Gastrointestinal tract perforation: MDCT findings according to the perforation sites. Korean J Radiol 2009;10(1):63-70.
Cianci R, Bianco V, Esposito G, et al. MDCT imaging of gastrointestinal tract perforation due to foreign body ingestion. Imaging of Alimentary Tract Perforation 2015:79-84.
Kothari K, Friedman B, Grimaldi GM, et al. Nontraumatic large bowel perforation: spectrum of etiologies and CT findings. Abdominal Radiology 2017;42:2597-608.
Dua, N. Morgan, A. Kichenaradjou, foreign bodies. Int J Oral Maxillofac Surg 2011;40(10):1149.