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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Medicine+(Baltimore)
2018 ; 97
(16
): e0427
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Sonographic and CT imaging features of intestinal perforation from a pill and
packing: A case report
#MMPMID29668604
Gou ZH
; Peng Y
; Yang K
Medicine (Baltimore)
2018[Apr]; 97
(16
): e0427
PMID29668604
show ga
RATIONALE: Sharp foreign bodies such as toothpicks or chicken bones can lead to
intestinal perforation. Small intestinal perforation secondary to foreign body
ingestion is usually manifested as an acute abdomen without a history of trauma.
Here we describe the diagnosis and treatment of a case of small bowel perforation
caused by an ingested pill and its outer packing. PATIENT CONCERNS: An 84 years
old male patient complained of right lower abdominal pain for 4 days and the pain
was becoming progressively worse. DIAGNOSES: The patient, who has Alzheimer's
disease, mistakenly took the pill (oxiracetam) without removing the outer
packaging. This resulted in perforation of the small intestine. INTERVENTIONS:
During the ultrasound examination, the scanning physician discovered that the
abnormal sonographic findings present could not be explained by the leading
diagnosis of perforation of the small intestine at the time. This led the
physician to suspect small bowel perforation secondary to a foreign body. The
subsequent computerized tomography (CT) examination further confirmed the
ultrasound findings. OUTCOMES: Emergency laparotomy was performed and the foreign
body was removed. After the surgical procedure, the patient resumed
anti-inflammatory treatment (Cefoxitin sodium 2000mg tid) and rehydration therapy
(Sodium Chloride Solution 100mL tid). LESSONS: Because ingestion of foreign
bodies of this type is relatively rare, when patients cannot provide an accurate
history, diagnosis can be quite difficult. In this paper, the imaging features
associated with intestinal perforation secondary to foreign body ingestion on
ultrasound and CT are described. This series of events demonstrate how imaging
findings can guide and alter a clinician's decision-making.