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Mohamedahmed AYY, Jouni H, Kakarla J, Ebraheem M, Eccersley J. Sigmoid Colon Perforation, Pelvic Collection, and Hydronephrosis Caused by an Ingested Chicken Wishbone. Cureus 2024; 16:e52478. [PMID: 38370995 PMCID: PMC10870089 DOI: 10.7759/cureus.52478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/18/2024] [Indexed: 02/20/2024] Open
Abstract
This case report presents an unusual and challenging case of an 82-year-old female patient who presented with constipation and abdominal pain and was diagnosed with bowel perforation and hydronephrosis caused by an ingested chicken wishbone. This patient was treated with emergency laparotomy and bowel sigmoid resection. She made a good recovery and was discharged home. The patient's clinical presentation, diagnostic challenges, and successful management are discussed.
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Affiliation(s)
| | - Hassan Jouni
- General Surgery, University Hospitals of Derby and Burton, Burton-on-Trent, GBR
| | - Jyotsna Kakarla
- General Surgery, University Hospitals of Derby and Burton, Burton-on-Trent, GBR
| | - Mohamed Ebraheem
- General Surgery, University Hospitals of Derby and Burton, Burton-on-Trent, GBR
| | - James Eccersley
- Colorectal Surgery and General Surgery, University Hospitals of Derby and Burton, Burton-on-Trent, GBR
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Smith T, Blum R, Rozdolski R. Management of an Ingested Foreign Body in a COVID-Positive Patient. Anesth Prog 2023; 70:178-183. [PMID: 38221701 PMCID: PMC11088193 DOI: 10.2344/anpr-70-03-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 05/09/2023] [Indexed: 01/16/2024] Open
Abstract
This case report describes a 51-year-old man who swallowed an amalgam fragment dislodged during dental treatment performed without a throat screen. The patient was transferred to the emergency department, where the foreign body was confirmed to be in the esophagus following radiographic imaging. Foreign body removal from the esophagus is routinely achieved via esophagogastroduodenoscopy (EGD). However, this incident occurred in September 2020, at the height of the COVID-19 pandemic. Because of the patient's preoperative positive COVID-19 test, the option for EGD retrieval was eliminated per hospital protocol. Instead, a noninvasive approach with serial radiographic monitoring was deemed mandatory to observe the fragment as it passed through the gastrointestinal tract, warranted by the small size of the foreign body and the patient's lack of signs and symptoms of respiratory distress. This case report reinforces the importance of using airway protection during every dental procedure. Furthermore, reevaluation of EGD as the gold standard for treatment of ingested small materials may be warranted.
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Affiliation(s)
- Tiffany Smith
- Touro College of Dental Medicine, Hawthorne, New York
| | - Rachel Blum
- Touro College of Dental Medicine, Hawthorne, New York
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Fallatah AA, Mashbari H, Daghestani H, Mostafa O, Alshahwan N, Alburakan A, Nouh T. Toothpick perforates small bowel-mimicking diverticulitis. J Surg Case Rep 2023; 2023:rjad511. [PMID: 37727225 PMCID: PMC10506890 DOI: 10.1093/jscr/rjad511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Accepted: 08/29/2023] [Indexed: 09/21/2023] Open
Abstract
Bowel perforation is an emergency condition that requires critical thinking and readily intervention; nevertheless, on occasions, its presentation can be challenging to diagnose. Several etiologies could cause bowel perforation, including obstruction, mass, inflammation, ischemia, etc. On rare occasions, a foreign body could be the cause of perforation, which mandates a detailed history and focused review of the images when the patient's condition allows. We report a case of ileal perforation caused by an ingested wooden toothpick that was suspected on the CT images, which the patient has no memory of ingesting.
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Affiliation(s)
- Ahmed A Fallatah
- Trauma and Acute Care Surgery Unit, Department of Surgery, College of Medicine, King Saud University, P.O Box 2925 Riyadh 11461, Saudi Arabia
- General Surgery Section, Department of Surgery, King Abdulaziz Hospital, Ministry of Health, P.O Box 3665 Jeddah 22421, Saudi Arabia
| | - Hassan Mashbari
- Department of Surgery, Faculty of Medicine, Jazan University, P.O Box 6809 Jazan 82817-28204, Saudi Arabia
| | - Hatoon Daghestani
- Trauma and Acute Care Surgery Unit, Department of Surgery, College of Medicine, King Saud University, P.O Box 2925 Riyadh 11461, Saudi Arabia
| | - Omar Mostafa
- College of Medicine, Sulaiman Al Rajhi University, P.O Box 777 Albukairiyah 51941, Saudi Arabia
| | - Nawaf Alshahwan
- Trauma and Acute Care Surgery Unit, Department of Surgery, College of Medicine, King Saud University, P.O Box 2925 Riyadh 11461, Saudi Arabia
| | - Ahmed Alburakan
- Trauma and Acute Care Surgery Unit, Department of Surgery, College of Medicine, King Saud University, P.O Box 2925 Riyadh 11461, Saudi Arabia
| | - Thamer Nouh
- Trauma and Acute Care Surgery Unit, Department of Surgery, College of Medicine, King Saud University, P.O Box 2925 Riyadh 11461, Saudi Arabia
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Majjad I, Shubietah AR, Alaqra Y, Alrabi I, AbuMohsen HMA, Aburumh H. Perforation of ileum by unnoticed toothpick ingestion presenting as acute appendicitis: A case report. Int J Surg Case Rep 2022; 102:107841. [PMID: 36543060 PMCID: PMC9794874 DOI: 10.1016/j.ijscr.2022.107841] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 12/13/2022] [Accepted: 12/15/2022] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION Many distinct pathologic disorders can cause acute abdomen, and it can be challenging for doctors to distinguish between them. Appendicitis and small bowel perforation are two examples. This case is being reported to highlight a rare instance in which acute appendicitis can be mistaken for ileal perforation by sharp solid objects. CASE PRESENTATION We discuss the case of a 9-year-old boy who arrived at our hospital complaining of right iliac fossa abdominal pain that started two days earlier with no other associated symptoms. Physical examination revealed right iliac fossa tenderness and rebound tenderness. The results of the imaging and laboratory tests were inconclusive; therefore, the patient was admitted for observation and further assessment. Re-evaluation 4 h after admission found no clinical improvement, and abdominal examination revealed guarding and rebound tenderness, prompting the surgical team to opt for an appendectomy. During surgery, an elliptical incision was made to remove a sharp foreign body penetrating the ileum. DISCUSSION Even during surgery, diagnosing acute appendicitis is difficult. Some cases of small bowel perforation caused by foreign body ingestion have been linked to a clinical picture similar to acute appendicitis, while others present with acute peritoneal signs. This report describes a sealed ileal perforation by a sharp solid object, manifested as acute appendicitis. CONCLUSION Perforation of the small bowel by sharp solid objects may easily be missed on imaging, probably related to their ability to seal off the resulting perforation. A sharp solid object's perforation seems to cause localized tenderness mimicking appendicitis.
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Affiliation(s)
- Ibrahem Majjad
- Department of Surgery, Rafidia Government Surgical Hospital, Nablus, Palestine
| | - Abdalhakim R.M. Shubietah
- Palestinian Ministry of Health, Darwish Nazzal Government Hospital, Qalqilya, Palestine,Correspondence to: A.R.M. Shubietah, Palestinian Ministry of Health, Darwish Nazzal Government Hospital, Qalqilya 00970, PO Box 7, Palestine.
| | - Yousef Alaqra
- Department of Emergency Medicine, Rafidia Government Surgical Hospital, Nablus, Palestine
| | - Ibrahim Alrabi
- Department of Surgery, Rafidia Government Surgical Hospital, Nablus, Palestine
| | - Haytham Mohamad Ali AbuMohsen
- Palestinian Ministry of Health, Tubas Government Hospital, Tubas, Palestine,Correspondence to: H.M.A. AbuMohsen, Palestinian Ministry of Health, Tubas Government Hospital, Tubas 00970, PO Box 7, Palestine.
| | - Hend Aburumh
- Palestinian Ministry of Health, Jenin Government Hospital, Jenin, Palestine
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Asaad HR, Faraj HI, Altom A, Ahmed SA, Muhammad BK, Rashid MJ, Aziz JMA, Khdhir RH, Huy NT. Abdominal pain from ingested bone misdiagnosed as appendicitis: Report of a rare case and literature review. Radiol Case Rep 2022; 17:4111-4114. [PMID: 36065240 PMCID: PMC9439961 DOI: 10.1016/j.radcr.2022.07.108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 07/26/2022] [Accepted: 07/31/2022] [Indexed: 11/17/2022] Open
Abstract
Bones are potential foreign bodies that could be accidentally ingested, leading to several symptoms varying from asymptomatic to perforation of the gastrointestinal tract. However, these cases are rare but may be misdiagnosed with other common diseases such as appendicitis. We present in this case a 25-year-old male who presented with appendicitis symptoms, after appendectomy the patient had the same complaint, But the colonoscopy demonstrated a meat bone in the terminal ileum and was removed with the same device. Finally, he was discharged from the hospital without complications and after decreasing abdominal pain. According to the literature review, this is one of the rare cases of using colonoscopy to treat bone impaction non-operatively.
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Affiliation(s)
- Hoshman Rahman Asaad
- Baxshin Research Center, Baxshin Hospital, Sulaimani, Kurdistan Region, Iraq
- Kurdistan Center for Gastroenterology and Hepatology, Sulaimani, Kurdistan, Iraq
| | - Heero Ismael Faraj
- Kurdistan Center for Gastroenterology and Hepatology, Sulaimani, Kurdistan, Iraq
| | - Ahmed Altom
- Department of Internal Medicine, Faculty of Medicine, Damascus University, Damascus, Syrian Arab Republic
| | | | - Bakhtyar Kamal Muhammad
- Baxshin Research Center, Baxshin Hospital, Sulaimani, Kurdistan Region, Iraq
- Anesthesia Department Technical, College of Health, Sulaimani, Polytechnic University, Kurdistan Region, Iraq
| | | | - Jeza M. Abdul Aziz
- Baxshin Research Center, Baxshin Hospital, Sulaimani, Kurdistan Region, Iraq
- Medical laboratory science, College of health sciences, University of Human Development, Sulaimani, Kurdistan Region, Iraq
- Corresponding authors.
| | | | - Nguyen Tien Huy
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, 852-8523, Japan
- Corresponding authors.
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Unknown ingestion of dentures – Review and description of a case report. INTERNATIONAL JOURNAL OF SURGERY OPEN 2022. [DOI: 10.1016/j.ijso.2022.100441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Rodriguez JER, Coelho DPD, Villalaz EDS, Figueiredo AR, Martins PDK, Guimarães JJP, de Souza AMC, Guimarães AGDP. Rectosigmoid transition perforation by ingá ( Inga laurina) seeds in the Brazilian amazon: Case report and surgical treatment. Ann Med Surg (Lond) 2021; 70:102897. [PMID: 34691434 PMCID: PMC8519804 DOI: 10.1016/j.amsu.2021.102897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Revised: 09/25/2021] [Accepted: 09/26/2021] [Indexed: 11/29/2022] Open
Abstract
Introduction Foreign body ingestion is a common clinical scenario found in clinical practice. Perforations related to foreign bodies are rare, but they can present as a serious condition in emergency surgery services. The most common sites of perforation are angled areas, such as: ileocecal valve, sigmoid colon, duodenojejunal flexure and small intestine. We are going to describe a rare case of extensive perforation of rectosigmoid transition, without associated obstructive clinical picture, related to voluntary ingestion of foreign body caused by multiple seeds of a typical amazon fruit. Presentation of case This case report describes the presentation and management of a 46-year-old man who presented signs of acute perforating abdomen, without obstructive condition, after ingestion of foreign body. Imaging examination revealed the presence of foreign bodies with signs of intestinal perforation. Exploratory laparotomy was performed to treat the lesion and remove foreign bodies. Discussion Bowel perforation by a non-sharp foreign body is a rare complication of object ingestion. Object shape, quantity, narrowing of gastrointestinal tract are factors that can favor perforation. The clinic is not very specific, usually preceded by when obstructive or sub occlusive, and the clinical history is relevant for diagnostic formulation. Regions and cultures with a high intake of food with seeds may constitute an extra risk factor. Conclusion The importance of alerting surgical teams to the possibility of bowel perforation without associated occlusive conditions caused by multiple non-sharp seeds is highlighted, as well as the need for early treatment aiming at favorable clinical outcome. Intestinal perforation by multiple non sharp fruits seeds is rare It is possible that there is no intestinal obstruction before perforation The use of protective terminal colostomy as described is an option
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Rajaguru K, Sheong SC. Case report on a rare cause of silent duodenal perforation. Int J Surg Case Rep 2020; 76:320-323. [PMID: 33065491 PMCID: PMC7567171 DOI: 10.1016/j.ijscr.2020.09.184] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 09/27/2020] [Accepted: 09/27/2020] [Indexed: 11/15/2022] Open
Abstract
We describe a rare case of duodenal perforation related to foreign body ingestion which has rarely been reported in the literature. Foreign body perforations were uncommon and often missed in view of its atypical and latent presentation. Early multiplanar reformatting CT images help in identifying the cause and also to locate the foreign body in most of the patients, thus making it an important tool for preoperative diagnosis which assists in surgical planning. Though the majority of patients will require an exploratory laparotomy, minimally invasive procedures can be attempted in stable patients similar to this case.
Introduction Foreign body ingestion is a common clinical scenario encountered in clinical practice. Perforations related to foreign bodies are rare (<1%) but can present as a serious element in Emergency surgery. The most common site of perforations are angulated areas like ileocecal valve, sigmoid colon and duodeno-jejunal flexure and small bowel. We describe a rare case of duodenal perforation related to foreign body ingestion which has rarely been reported in the literature. Case presentation and management This case report describes the presentation and management of a 65 year old male who presented with septic shock without symptoms and signs of an acute abdomen. Imaging revealed a sealed foreign body perforation in the first part of duodenum with a localized abscess. The abscess cavity was drained and the foreign body (fish bone) was removed laparoscopically. Conclusion Foreign body perforations were often missed in view of its atypical and latent presentation with the history of foreign body ingestion is rare. Early multiplanar reformatting CT images help in identifying the cause and also to locate the foreign body in most of the patients, thus making it an important tool for preoperative diagnosis which assists in surgical planning. Though the majority of patients will require an exploratory laparotomy, minimally invasive procedures can be attempted in stable patients similar to this case.
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Affiliation(s)
- Kishore Rajaguru
- Ng Teng Fong General Hospital, Department of General Surgery, National University Health System, Singapore.
| | - Seow Choon Sheong
- Ng Teng Fong General Hospital, Department of General Surgery, National University Health System, Singapore
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