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
Collapse