Case of unrecognised food bone ingestion with dual site intestinal perforations

Coyte, Aishah; Aïssa, Jamel Tahar; Koh, Hoey C.; MacKay, Graham J

doi:10.1136/bcr-2015-213767

Cited by 4 publications

(6 citation statements)

References 11 publications

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“…Typically, the FB passes through the gastrointestinal tract after one week with no complications [ 4 – 6 ]. Less than 1% of FB ingestions cause intestinal perforations [ 5 ]. Some patients do not recall the inciting ingestion [ 3 ].…”

Section: Discussionmentioning

confidence: 99%

“…Complications of a FB may take months to even years to manifest [ 4 ]. Interestingly, complications of a FB can also mimic appendicitis and diverticulitis [ 5 ].…”

Section: Discussionmentioning

confidence: 99%

“…Dentures are a risk factor. Alcoholism, mental illness, and intestinal strictures are also risk factors [ 5 ].…”

Section: Discussionmentioning

confidence: 99%

“…The most common complication below the diaphragm is perforation. Owing to their narrow lumen and high angulation, the terminal ileum and the rectosigmoid junction are the usual sites of perforation [ 5 ]. Transmigration through the duodenum has also been reported [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

“…The site of perforation may be closed off by the resulting inflammatory changes or by the omentum. Because of these mechanisms, such perforations rarely lead to peritonitis [ 4 , 5 ].…”

Section: Discussionmentioning

confidence: 99%

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Ingested Foreign Body Migration to the Liver: An Unusual Cause of Persistent Abdominal Pain in a 54-Year-Old Female

Lucerna

Espinosa

Schuitema

et al. 2018

Case Reports in Emergency Medicine

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Abdominal pain is a common presentation in emergency medicine. We describe the case of a 54-year-old female who presented to the emergency department due to worsening abdominal pain. She had a history of right upper quadrant (RUQ) abdominal pain that had been ongoing for several months. The pain had been thought by the primary care team to be related to gastritis and she had been prescribed a proton pump inhibitor (PPI). Her abdominal pain increased in the three days prior to her presentation to the emergency department (ED). The computed tomography (CT) scan of the abdomen showed a foreign body (FB) in the liver which was successfully removed surgically. Pathology results showed that the FB was consistent with a small bone fragment. Ingestions of FB are common but seldom result in complications. When complications do arise, perforation of a hollow viscous is typically seen. Rarely, transmigration of the FB can occur.

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Section: Discussionmentioning

confidence: 99%

“…Complications of a FB may take months to even years to manifest [ 4 ]. Interestingly, complications of a FB can also mimic appendicitis and diverticulitis [ 5 ].…”

Section: Discussionmentioning

confidence: 99%

“…Dentures are a risk factor. Alcoholism, mental illness, and intestinal strictures are also risk factors [ 5 ].…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…The site of perforation may be closed off by the resulting inflammatory changes or by the omentum. Because of these mechanisms, such perforations rarely lead to peritonitis [ 4 , 5 ].…”

Section: Discussionmentioning

confidence: 99%

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Ingested Foreign Body Migration to the Liver: An Unusual Cause of Persistent Abdominal Pain in a 54-Year-Old Female

Lucerna

Espinosa

Schuitema

et al. 2018

Case Reports in Emergency Medicine

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Foreign bodies in sigmoid colon diverticulosis

Ross

McKenna

Anderson

2017

Clin J Gastroenterol

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This review addresses the management of sigmoid colon diverticular disease associated with foreign bodies. In addition, two novel cases are presented. One case describes the management of diverticular bleeding secondary to a chicken bone and the other case reports retrieval of a retained EndoRings™ Device. The review identified 40 relevant publications including 50 subjects. Foreign bodies within sigmoid diverticular disease may be associated with inflammation, perforation, abscess and fistula. In current practice, diagnosis is often achieved with CT scan. Patients with colonic perforation or fistula generally require colonic resection. Patients with inflammation may merit conservative management, including colonoscopic foreign body retrieval. Chicken bones, tooth picks, and biliary stents have been reported in patients with inflammation, perforation and fistula, whereas all published patients with fish bone related diverticulosis complications experienced inflammation. Treatment might be best guided by the consequences of the foreign body rather than the nature of the underlying retained object. Diverticular bleeding secondary to a chicken bone was diagnosed at CT angiography and treated with colonoscopic snare retrieval of the bone and clipping of the bleeding diverticulum. The EndoRings™ Device was retrieved with a colonoscopic balloon.

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Unusual Presentation of a Sigmoid Mass with Chicken Bone Impaction in the Setting of Metastatic Lung Cancer

Zeidan

Lwin

Iswariah

et al. 2019

Case Reports in Surgery

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Background. Ingestion of foreign bodies can cause various gastrointestinal tract complications including abscess formation, bowel obstruction, fistulae, haemorrhage, and perforation. While these foreign body-related complications can occur in normal bowel, diseased bowel from inflammation, strictures, or malignancy can cause diagnostic difficulties. Endoscopy is useful in visualising the bowel from within, providing views of the mucosa and malignancies arising from here, but its ability in diagnosing extramural malignancies arising beyond or external to the mucosa of the bowel as in the case of metastatic extramural disease can be limited. Case Summary. We present the case of a 60-year-old female with an impacted chicken bone in the sigmoid colon with formation of a sigmoid mass, on a background of metastatic lung cancer. On initial diagnosis of her lung cancer, there was mild Positron Emission Tomography (PET) avidity in the sigmoid colon which had been evaluated earlier in the year with a colonoscopy with findings of diverticular disease. Subsequent computed tomography (CT) scans demonstrated thickening of the sigmoid colon with a structure consistent with a foreign body distal to this colonic thickening. A repeat PET scan revealed an intensely fluorodeoxyglucose (FDG) avid mass in the sigmoid colon which was thought to be inflammatory. She was admitted for a flexible sigmoidoscopy and removal of the foreign body which was an impacted chicken bone. She had a fall and suffered a fractured hip. During her admission for her hip fracture, she had an exacerbation of her abdominal pain. She developed a large bowel obstruction, requiring laparotomy and Hartmann’s procedure to resect the sigmoid mass. Histopathology confirmed metastatic lung cancer to the sigmoid colon. Conclusion. This unusual presentation highlights the challenges of diagnosing ingested foreign bodies in patients with metastatic disease.

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Case of unrecognised food bone ingestion with dual site intestinal perforations

Cited by 4 publications

References 11 publications

Ingested Foreign Body Migration to the Liver: An Unusual Cause of Persistent Abdominal Pain in a 54-Year-Old Female

Ingested Foreign Body Migration to the Liver: An Unusual Cause of Persistent Abdominal Pain in a 54-Year-Old Female

Foreign bodies in sigmoid colon diverticulosis

Unusual Presentation of a Sigmoid Mass with Chicken Bone Impaction in the Setting of Metastatic Lung Cancer

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