Duodenal perforation nine months after accidental foreign body ingestion, a case report

Occurrence of multiple fistulas decades after ingestion and neglect of numerous thermometers: a case report

BACKGROUND

Ingestion of thermometers is a very rare occurrence and associated with penetrations of hollow organs. An event decades ago can lead to the development of fistulas.

CASE PRESENTATION

We present a case of a 62-year-old male who swallowed multiple thermometers with a length of up to 22 cm over a period of 40 years. Diagnostic imaging presented a retroperitoneal abscess due to a duodenal perforation of the longest thermometer as well as multiple other thermometers stuck in the small intestine. After all thermometers were removed and the abscess drained, the patient showed a clinical deterioration. In further operations we found a duodeno-sigmoid fistula and a gastro-thoracal fistula, which were not visible in the initial operations and imaging.

CONCLUSION

We recommend an active search for fistulas especially in the case of long-foregone ingestion.

A Gastric Magnetic Foreign Body Incidentally Detected Several Years after Ingestion

Foreign body ingestion is commonly seen in children. However, occasionally it may also be seen among adults and is often associated with intellectual disability, psychiatric disorders, and alcoholism. Ingestion of a magnetic foreign body may cause complications such as gastrointestinal tract perforation, wherein emergency endoscopic removal of the foreign body is generally required. Here, we report a rare case of a 59-year-old male with an intellectual disability and psychiatric disorder in whom metallic objects in the stomach cavity were accidentally discovered during abdominal CT. Esophagogastroduodenoscopy revealed several metallic objects attached to two magnets, which had been ingested several years before and had remained in the stomach cavity. The magnets and metallic objects were safely removed endoscopically using rat-tooth forceps without complications.

Multiple abdominopelvic abscesses caused by fishbone: A case report of rare etiology and literature review

INTRODUCTION AND IMPORTANCE

Foreign body ingestion, particularly fishbone, is a prevalent medical complaint in the emergency department. Usually, these foreign substances pass through the gastrointestinal tract without causing any complications. The clinical manifestations of foreign body consumption are non-specific.

CASE PRESENTATION

A 32-year-old male patient presented to our hospital with severe abdominal pain. Physical examination revealed a distended abdomen and tenderness. Plain chest and abdominal X-rays were unremarkable. The performed computed tomography (CT) of the abdominopelvic region showed multiple abscesses. Then, an exploratory laparotomy was decided during which a foreign body, a fishbone, was detected and the affected omental mass was resected, and abscess drainage was done. The resected specimen was sent for histopathological studies. The postoperative period was uneventful.

CLINICAL DISCUSSION

Perforation of the intestinal wall by fishbone ingestion is an unusual entity. The clinical features of intestinal perforation are usually non-specific resulting in delayed diagnosis. Based on individual situations, the treatment strategy can be surgical or non-surgical.

CONCLUSION

Even though ingesting a foreign body is a frequent complaint in clinical practice, its repercussions are extremely rare. Our case presented multiple intra-abdominal abscesses and perforation as a complication of accidental fishbone ingestion.

Intentional Ingestion of a Metallic Wire Causing Perforation and Retroperitoneal Abscess: A Case Report

Foreign body ingestion is a frequent condition, with the majority of foreign bodies (FBs) tending to spontaneously proceed along the gastrointestinal tract without any major complications. A wide range of procedures are available to remove FBs; however, a real challenge exists in managing sharp, rigid, and long foreign objects, which are related to higher rates of complications. A 34-year-old man who intentionally swallowed a metallic wire of 20 cm length, presented to our ED with abdominal pain 2 weeks after the ingestion. The FB had migrated to the stomach and duodenum. Complications included perforation of the duodenum and ascending colon and a retroperitoneal abscess. FB removal was done via laparotomy, followed by the repair of perforations and damaged tissues. This case highlights the complications of a FB presence in the gastrointestinal tract for 14 days and emphasizes the importance of urgent and appropriate management of such conditions.

Migration of fish bones into abdominal para-aortic tissue from the duodenum after leading to duodenal perforation: a case report

Background

Migration of fish bones into abdominal para-aortic tissue after penetrating the junction of 3rd and 4th part of duodenum is incredibly rare.

Case presentation

A 68-year-old man was admitted to our hospital with persistent colic in the lower abdomen after eating fish two weeks ago. Abdominal computed tomography (CT) scan showed High density streaks along the anterior and lower edges of the 3rd part of duodenum with peripheral exudation and localized peritonitis. Esophagogastroduodenoscopy didn’t find foreign bodies and perforations in the digestive tract. Laparoscopic surgery and intraoperative endoscopy were made to detect foreign bodies and perforation site was found. After transition to open surgery, the fish bone was found in abdominal para-aortic tissue and removed without complications. Postoperative recovery is smooth, and the patient resumed normal diet and was discharged.

Conclusions

It is difficult to choose a treatment plan for foreign bodies at the 3rd part of the duodenum, because it is difficult to judge the damage caused by the foreign body to the intestine and the positional relationship with the surrounding important organs. Conservative treatment or surgical treatment both have huge risks. The handling of this situation will extremely test the psychology, physical strength and professional experience of the surgeon.