Perforation of the gastrointestinal tract by ingested foreign body

Case contributed by Dr Bruno Di Muzio

Presentation

Patient comes to the emergency department with complaints of severe abdominal pain, diffuse, about 12 hours. It has no fever, vomiting and other intestinal symptoms. Prior history of diverticulitis. Physical examination: abdomen diffusely painful and limp.

Patient Data

Age: 72
Gender: Female
CT

The patient underwent CT without contrast as institutional protocol for acute abdomen in the elderly.

There is increased attenuation of fat planes in the epigastric region (blurring), associated with small bubbles of gas pneumoperitoneum. Identified linear fragment of high attenuation (Radiopaque foreign body), shaped as a "y", within the third portion of duodenum.

Numerous scattered colonic diverticula, including the transverse colon.

Annotated image

Notes on reformatting image demonstrates the findings.

Radiopaque foreign body into duodenum. 

Case Discussion

The patient underwent emergency surgery. 

Perforation occurs in less than 1% of ingested foreign bodies. Known agents include chicken and fish bones, toothpicks, dentures and cocktail sticks. 

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Case information

rID: 17797
Case created: 13th May 2012
Last edited: 22nd Jan 2016
Inclusion in quiz mode: Included

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