Intestinal Perforation by Foreign Body: Case Report and Literature Review

Author(s)

Dr. Marlon D. Brown MD, MPH ,

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Volume 6 - December 2017 (12)

Abstract

The ingestion of foreign bodies intentionally or accidentally is found worldwide especially in paediatric age group (8), elderly, mentally subnormal individuals, alcoholic and drug abusers proving to be a major cause of morbidity and mortality (7).  The ingestion of foreign bodies is rarely associated with intestinal perforation, even if a sharp object is swallowed. About 80-90% of ingested foreign bodies are passed spontaneously (5).  The consequences may range from un-noticed passage per rectum to severe peritonitis following bowel perforation although less than 1% causes perforation (6) and there may be acute bowel obstruction.
Method:
This is a 21 year old male patient who presented with abdominal pain. This patient states that the abdominal pain started after the ingestion of liquid. On physical examination the abdomen was firm, flat, no surgical scars, with generalized tenderness and guarding principally in the epigastric to suprapubic region. The investigations which were done had essentially contributed no additional information suggestive of the definitive pathology.
Result:
This patient was resuscitated with intravenous fluid therapy, analgesia, prophylactic antibiotic along with deep vein thrombosis prophylaxis and booked for exploratory laparotomy. The findings at laparotomy are that of a perforated proximal loop of jejunum with a piece of chicken bone.
Conclusion:
The vague symptoms that can be found on physical examination as well as the lack of patients ability to recall whether or not they had ingested a foreign body is the main difficulty in the diagnosis of this entity. 

Keywords

intestinal perforation, foreign body, chicken bone

References

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