An Unusual Case of Duodenal Perforation Caused by a Lollipop Stick: A Case Report

Abstract

Most ingested foreign bodies often pass through the gastrointestinal tract uneventfully; however, complications such as perforation do occur. Most cases of perforation are caused by thin, pointed objects such as needles, toothpicks, or fish and chicken bones. Herein, we report an unusual case of duodenal perforation caused by a lollipop stick with blunt ends. A 23-year-old woman was admitted to the emergency department complaining of epigastric and right upper quadrant pain for the last 2 days. Abdominal computed tomography scans confirmed the presence of a foreign body in the duodenum, with signs of duodenal perforation and inflammation. The patient was not aware of ingesting the foreign body. Endoscopy revealed the presence of a lollipop stick in the duodenum, which was removed with forceps. The duodenal perforation was successfully managed by using hemoclips and a detachable snare.

A Swallowed Metal Nail Entrapped in the Right Psoas Muscle

“…An orally ingested object passes through the oropharynx, pharynx, esophagus, cardia, pylorus, duodenum, small intestine, and colon, sometimes leading to obstruction and perforation at the anorectal level before penetrating into the rectoanal region. [5,[7][8][9] Objects smaller than 6 cm and those with a structure thinner than 2 cm require no intervention and are naturally discharged. [5] In some cases, the ingested object remains in the body with no symptoms, and leads to unexpected complication after a long period.…”

“…[5,[7][8][9] Objects smaller than 6 cm and those with a structure thinner than 2 cm require no intervention and are naturally discharged. [5] In some cases, the ingested object remains in the body with no symptoms, and leads to unexpected complication after a long period. Misra et al suggested that conservative treatment of asymptomatic cases is ideal, and that intervention should be performed following onset of first symptom.…”

“…However, laparoscopy and laparotomy may also be required in cases of perforation or obstruction. [2,5] Following foreign body retrieval, treatment of mental disorder, if applicable, in order to prevent repeated ingestion, is of prime importance. [1] Presently described were the clinical properties of a mentally retarded woman with repeated foreign body ingestion, who ingested a 12-cm nail, which became entrapped in the right psoas muscle after perforating the third portion of the duodenum.…”

“…These objects may be made of plastic, metal, or toxic material. [1][2][3][4][5][6][7][8][9] Most ingested foreign bodies are naturally discharged from the body within 4-6 days. However, serious complications in the gastrointestinal system such as obstruction or perforation may occur, requiring surgical intervention.…”

“…These complications may also be associated with clinical presentations such as nausea, vomiting, and acute abdomen, depending on the location and severity of the obstruction and perforation. [1,[5][6][7][8][9] Endoscopic approach is the method of choice in the treatment of ingested foreign bodies. However, laparoscopy and laparotomy may also be required in cases of perforation or obstruction.…”