Jejunal perforation due to ingested buffalo bone mimicking acute appendicitis

Abstract

BackgroundForeign body ingestion is seen quite frequently in clinical practice, intestinal perforation due to this is rare. The foreign body often mimics another cause of acute abdomen and requires an emergency surgical intervention. The majority of patients do not recall ingesting sharp foreign bodies.Case presentationWe report an interesting case of a fifty five year-old man who presented with pain in the right iliac fossa with localised tenderness which was clinically diagnosed as acute appendicitis. During the operation, the presence of purulent collection and the inflamed bowel with flakes raised suspicion of bowel perforation. The assessment of the proximal small bowel revealed two small perforations in the jejunum. A hard, bony and sharp object was extracted and the perforations were closed. Post-operative recovery was uneventful. Detailed food history was taken following the recovery of the patient from surgery. It revealed the history ingestion of home prepared buffalo meat. The extracted object was identified as ‘buffalo bone’ by the patient and the care taker of the patient. The jejunum was perforated by the ingested buffalo bone causing local peritonitis in right iliac fossa.ConclusionIntestinal perforation by ingested foreign bodies should be suspected in acute abdomen. It requires a high degree of suspicion and awareness on the part of the clinician.Electronic supplementary materialThe online version of this article (doi:10.1186/s13104-016-2127-y) contains supplementary material, which is available to authorized users.

Report of a case mimicking the acute appendicitis; Small bowel perforation due to olive leaf

“…Various foreign bodies such as toothpicks, fishbones, chicken, or cattle bones and dentures have been reported in the literature. [ 3 , 4 ] The ingested foreign bodies are expected to be stuck in anatomically stenosis areas. The cricopharyngeal sphincter is the first one of them.…”

Abdominal pain from ingested bone misdiagnosed as appendicitis: Report of a rare case and literature review

“…Impaction places include distal duodenum, jejunum, terminal ileum, ileocecal junction, distal sigmoid colon, and Meckel's diverticulum. Additionally, all cases reported negative CT and Ultrasound scans, and the patients were only diagnosed with an ingested foreign bone then suggest laparoscopy and laparotomy [12] , [13] , [14] , [15] , [16] , [17] , [18] , [19] , [20] , [21] . Therefore, clinicians should not count very much on the imaging results to exclude the ingestion of foreign bodies despite its rarity.…”

Perforación de íleon distal por espina de pescado: reporte de caso

“…La perforación en estas áreas puede ser complicada por peritonitis la formación de abscesos y la peritonitis (10) . El absceso puede llevar a una hidronefrosis debido a la obstrucción de uréter (11) . La perforación de un divertículo de Meckel también puede ocurrir debido a la ingestión de hueso de pescado, o incluso una complicación más severa, puede ser la perforación en el área anorrectal, que puede provocar sepsis perianal y gangrena de Fournier (9) .…”