Foreign body ingestion of blister pill pack causing small bowel obstruction

Tai, Angela W.; Sodickson, Aaron

doi:10.1007/s10140-007-0582-4

Cited by 19 publications

(13 citation statements)

References 18 publications

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“…Nevertheless, the radiographic appearances of BPPs are typically identifiable by their aluminum foil backing and plastic blister surrounding the pill or tablet along with a thin rim of air. Their lateral appearance has been compared to that of a “UFO”[ 28 ]. It was also observed that the density of the pill itself could be extremely variable, some pills being completely radiolucent[ 4 ].…”

Section: Discussionmentioning

confidence: 99%

Rectal perforation by inadvertent ingestion of a blister pack: A case report and review of literature

Fleres

Ieni

Saladino³

et al. 2018

WJCC

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The accidental ingestion of a foreign body (FB) is a relatively common condition. In the present study, we report a peculiar case of rectal perforation, the first to our knowledge, caused by the inadvertent ingestion of a blister pill pack. The aim of this report is to illustrate the difficulties of the case from a diagnostic and therapeutic viewpoint as well as its unusual presentation. A 75-year-old woman, mentally impaired, arrived at our emergency department in critical condition. The computed tomography scan revealed a substantial abdominopelvic peritoneal effusion and free perigastric air. The patient was therefore submitted to an urgent exploratory laparotomy; a 2-cm long, full-thickness lesion was identified in the anterior distal part of the intraperitoneal rectum. Hence, we performed a Hartmann’s procedure. Because of her critical condition, the patient was eventually transferred to the Intensive Care Unit, where she died after 10 d, showing no surgical complication. The ingestion of FBs is usually treated with observation or endoscopic removal. Less than 1% of FBs are likely to cause an intestinal perforation. The intestinal perforation resulting from the unintentional ingestion of an FB is often a difficult challenge when it comes to treatment, due to its late diagnosis and the patients’ deteriorated clinical condition.

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Section: Discussionmentioning

confidence: 99%

Rectal perforation by inadvertent ingestion of a blister pack: A case report and review of literature

Fleres

Ieni

Saladino³

et al. 2018

WJCC

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“…And while studies suggest that social care support with medication management and the use of multi-compartment compliance aids improve adherence, clinical outcomes and quality of life [ 2 , 3 ], not all elderly people need such interventions; some are self-sufficient, and others are entirely reliant on these interventions [ 4 ]. For patients who need interventions, multi-compartment compliance aids may not be helpful in improving their drug management because dosage forms other than tablets and capsules may be unsuitable and patients with cognitive problems or blindness may ingest unit-dose blister packs [ 5 , 6 ]. Therefore, it is important to target interventions to those who need them.…”

Section: Introductionmentioning

confidence: 99%

Pilot evaluation of the psychometric properties of a self-medication Risk Assessment Tool among elderly patients in a community setting

Millar

Babigumira

2011

BMC Res Notes

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BackgroundAlthough community pharmacists in the United Kingdom are expected to assess elderly patients' needs for additional support in managing their medicines, there is limited data on potentially useful assessment tools. We sought to evaluate a 13-item assessment instrument among community dwelling elderly patients, 65 years and above. The instrument is composed of a cognitive risk sub-scale of 6 items and a physical risk sub-scale of 7 items.FindingsThe instrument was administered to elderly patients in a survey performed in a community to the west of Glasgow, Scotland. The survey recruited 37 participants, 31 from 4 community pharmacies and 6 patients whose medication management tasks were managed by the West Glasgow Community Health and Care Partnership (managed patients). Community pharmacists independently rated 29 of the 37 participants' comprehension of, and dexterity in handling their medicines. We assessed scale reliability, convergent validity and criterion validity. In sub-analyses, we assessed differences in scores between the managed patients and those recruited from the community pharmacies, and between multi-compartment compliance aid users and non-users. The instrument showed satisfactory internal consistency (Cronbach's alpha of 0.792 for 13-item scale). There was significant strong negative correlation between the cognitive risk sub-scores and community pharmacists' assessment of comprehension (ρ = -0.546, p = 0.0038); and physical risk sub-scores and community pharmacists' assessment of dexterity (ρ = -0.491, p = 0.0093). The Area Under the Receiver Operator Characteristic Curve (AUC ± SE; 95%CI) showed that the instrument had good discriminatory capacity (0.86 ± 0.07; 0.68, 0.96). The best cut-off (sensitivity, specificity) was ≥4 (65%, 100%). In the sub-analyses, managed patients had significantly higher cognitive risk sub-scores (6.5 versus 4.0, p = 0.0461) compared to non-managed patients. There was a significant difference in total risk score (4 versus 2, p = 0.0135) and cognitive risk sub-score (4 versus 1.5, p = 0.0029) between users and non-users of multi-compartment compliance aids.ConclusionsThis instrument shows potential for use in identifying elderly patients who may have problems managing their own medicines in the community setting. However, more robust validity and reliability assessments are needed prior to introduction of the tool into routine practice.

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“…All reported cases of ileal perforations caused by blister packs were not associated with intestinal obstruction, except for one case by Coulier et al ,9 where obstruction preceded perforation. Tai and Sodickson13 reported a case of intestinal obstruction without perforation, caused by ingestion of a blister pill pack. Perforation of intestinal structures by ingested foreign bodies is a challenging diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Obstruction and perforation of the small bowel caused by inadvertent ingestion of a blister pill pack in an elderly patient

et al. 2015

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Perforation of the small bowel due to foreign body ingestion is a rare instance that occurs in less than 1% of all ingestions. Although rare, ingestion of blister pill packaging is becoming more recognised as a causative agent for intestinal perforation, but is very rarely reported to cause intestinal obstruction. This is a report of a 66-year-old woman who presented with intestinal obstruction and underwent laparotomy, revealing small bowel perforation by a piece of blister pill pack foil. The patient was incognisant of the ingestion.

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Foreign body ingestion of blister pill pack causing small bowel obstruction

Cited by 19 publications

References 18 publications

Rectal perforation by inadvertent ingestion of a blister pack: A case report and review of literature

Rectal perforation by inadvertent ingestion of a blister pack: A case report and review of literature

Pilot evaluation of the psychometric properties of a self-medication Risk Assessment Tool among elderly patients in a community setting

Obstruction and perforation of the small bowel caused by inadvertent ingestion of a blister pill pack in an elderly patient

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