Chicken-bone perforation of a sigmoid colon diverticulum into the right groin and subsequent phlegmonous inflammation of the abdominal wall

Abstract

Colonic diverticula are frequent in western countries and approximately 80% of patients who develop diverticulitis are elderly. The sigmoid and descending colon are most commonly involved. Clinical manifestations range from asymptomatic diverticula to life-threatening complications such as diverticulum perforation and subsequent peritonitis. In a small percentage of cases ingestion of foreign bodies can cause perforation of the sigmoid diverticulum. Ingestion of foreign bodies such as chicken bones, fish bones, toothpicks and dentures usually has no consequence and only 5% of such cases require surgery. Patients frequently do not realize that they have ingested the foreign body and the cause of the damage is usually discovered intraoperatively or on pathological examination of the surgical specimen. We report an 82-year-old woman with perforation of a sigmoid diverticulum into the right groin with subsequent phlegmonous inflammation of the abdominal wall. A Hartmann's procedure with necrectomy of the abdominal wall was performed. Histopathologic examination revealed an ingested chicken bone perforating the diverticulum. When diverticulitis or diverticular abscess is suspected in an elderly patient, foreign body impaction or perforation should be considered as a possible cause.

Pigment Epithelium-Derived Factor Enhances Differentiation and Mineral Deposition of Human Mesenchymal Stem Cells

“…Human MSCs were plated onto 6 cm Petri dishes at density of 1 × 10 4 /cm 2 and pretreated with 20 μM of AKT kinase inhibitor (612847‐09‐3, Biovision, CA), 10 mM ERK docking domain inhibitor (294675‐79‐9, Sigma‐Aldrich, CA), or control solution (DMSO). This was followed by incubation of MSCs in a medium supplemented with 250 ng/ml of PEDF for 1, 5, 30 minutes, 3 hours, and 24 hours . Cells at each time point were extracted with RIPA buffer and the cell lysates were collected and used for Western blotting.…”

Abdominal Wall Abscess due to Acute Perforated Sigmoid Diverticulitis: A Case Report with MDCT and US Findings

“…Imaging will more likely detect the foreign body when it is metallic. Kornprat et al conclude by suggesting foreign body ingestion and perforation in the differential diagnosis of diverticular abscess, especially in elderly patients [10]. …”

Gastric perforation by a foreign body presenting as a pancreatic pseudotumour

“…Examples have been reported of cases of suspected appendicitis, 4,5 diverticulitis, 6 localised peritonitis, 7 abscesses 8,9 and even Ludwig's angina (cellulitis of the floor of the mouth) 10 secondary to foreign body perforations. As in our case, perforations of the stomach can be seen to present late and therefore result in further complications.…”