Small bowel perforation secondary to foreign body

Case contributed by Dr Ian Bickle

Presentation

This overweight lady in her 50's presented to A and E with RIF pain. Ultrasound suggested thickened omentum, with the radiologist suggesting CT after clinico-radiological assessment.

Patient Data

Age: 56
Gender: Female

A 4 cm high density linear foreign body is apparent anteriorly in the right iliac fossa, part of which traverses the wall of the jejunum.

Inflammatory change in the adjacent peritoneal fat.

No collection. No significant extra-luminal air.

The foreign body is being retrieved from the abdominal cavity.

It is thin, hard, and sharp - likely an ingested chopped chicken bone.

Case Discussion

A localized bowel perforation can occur following inadvertent ingestion of sharp foreign bodies.

Culprits include animal bones, fish bones, and toothpicks (I have seen the latter twice).

Minimal free or no free gas may be observed, but the object can be seen piercing the bowel wall, with associated inflammatory change. 

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Case information

rID: 29366
Published: 20th May 2014
Last edited: 16th Jul 2018
Inclusion in quiz mode: Included

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