Document Type : Case reports

Author

Department of Surgery (General Surgery), Al-Muqdadiya General Hospital, Diala Health Directorate, Diala, Iraq.

Abstract

The unwitting swallowing of a foreign body is not uncommon and rarely causes perforation of any part of the gastrointestinal tract. We have reported in this case of a 46-year-old man who presented with a clinical picture similar to a perforated peptic ulcer. At the laparotomy exploration, the case was a perforation of the sigmoid colon by a fishbone (6 cm in length). The foreign object was removed and the perforated site was closed by the primary suturing. There were no postoperative complications. Although intestinal perforation due to an ingested foreign object is seldom to be seen, the surgeon must be aware of its occurrence and put it as one of the differential diagnosis in a case of an acute abdomen. A detailed history and computerized tomography (CT) scan are essential tools to detect intestinal foreign bodies in subjects with acute abdomen.

Keywords

Main Subjects

[1]      G. M. Eisen et al., “Guideline for the management of ingested foreign bodies,” Gastrointest. Endosc., vol. 55, no. 7, pp. 802–806, 2002.
[2]      P. Mapelli, L. H. Head, W. E. Conner, W. E. Ferrante, and J. E. Ray, “Perforation of colon by ingested chicken bone diagnosed by colonoscope.,” Gastrointest. Endosc., vol. 26, no. 1, pp. 20–21, 1980.
[3]      S.-D. Hsu, D.-C. Chan, and Y.-C. Liu, “Small-bowel perforation caused by fish bone,” World J. Gastroenterol. WJG, vol. 11, no. 12, p. 1884, 2005.
[4]      A. P. Madrona, J. A. F. Hernández, M. C. Prats, J. R. Riquelme, and P. P. Paricio, “Intestinal perforation by foreign bodies,” Eur. J. Surg., vol. 166, no. 4, pp. 307–309, 2000.
[5]      B. Coulier, M.-H. Tancredi, and A. Ramboux, “Spiral CT and multidetector-row CT diagnosis of perforation of the small intestine caused by ingested foreign bodies,” Eur. Radiol., vol. 14, no. 10, pp. 1918–1925, 2004.
[6]      M. Maleki and W. E. Evans, “Foreign-body perforation of the intestinal tract: report of 12 cases and review of the literature,” Arch. Surg., vol. 101, no. 4, pp. 475–477, 1970.
[7]      B. K. P. Goh et al., “Perforation of the gastrointestinal tract secondary to ingestion of foreign bodies,” World J. Surg., vol. 30, no. 3, pp. 372–377, 2006.
[8]      L. Ginzburg and A. J. Beller, “The clinical manifestations of non-metallic perforating intestinal foreign bodies,” Ann. Surg., vol. 86, no. 6, p. 928, 1927.
[9]      S. Akhtar, N. McElvanna, K. R. Gardiner, and S. T. Irwin, “Bowel perforation caused by swallowed chicken bones–a case series,” Ulster Med. J., vol. 76, no. 1, p. 37, 2007.
[10]    M. Takada, R. Kashiwagi, M. Sakane, F. Tabata, and Y. Kuroda, “3D-CT diagnosis for ingested foreign bodies,” Am. J. Emerg. Med., vol. 18, no. 2, pp. 192–193, 2000.
[11]    E. Ross, P. McKenna, and J. H. Anderson, “Foreign bodies in sigmoid colon diverticulosis,” Clin. J. Gastroenterol., vol. 10, no. 6, pp. 491–497, 2017.
[12]    M. Watanabe et al., “Perforation of the sigmoid colon by an ingested fish bone,” Intern. Med., vol. 49, no. 11, pp. 1041–1042, 2010.
[13]    H. A. Owen, N. Srikandarajah, A. Aurangabadkar, K. Downey, and D. Melville, “Laparoscopic management of foreign body perforation in diverticular disease,” Ann. R. Coll. Surg. Engl., vol. 92, no. 7, pp. e24–e25, 2010.