02 May 2019 : Case report
Unusual clinical course, Challenging differential diagnosis, Diagnostic / therapeutic accidents, Management of emergency care, Educational Purpose (only if useful for a systematic review or synthesis)Giuseppe Cicero1AE*, Simona Caloggero1B, Marco Cavallaro1E, Luciano Frosina1E, Carmela Visalli1B, Velio Ascenti2F, Alfredo Blandino1D, Silvio Mazziotti1AE
Am J Case Rep 2019; 20:635-639
BACKGROUND: Diagnosis and management of accidental or intentional ingestion of foreign bodies is a common problem at in emergency departments. This condition is generally observed in patients with limited consciousness or attention, such as children, elders, or psychiatric patients. Here, we report a case of intestinal perforation caused by ingestion of a foreign body that occurred during the performance of a contrast-enhanced CT scan.
CASE REPORT: A 73-year-old diabetic woman was admitted to the emergency room of our hospital with postprandial abdominal discomfort, nausea, and vomiting. Under the suspicion of bowel ischemia, the patient underwent a contrast-enhanced CT scan. A thickened ileal loop with an endoluminal bone-density foreign body was detected. The following contrast-enhanced acquisitions additionally showed air bubbles adjacent to the loop, as the sign of an intestinal perforation that occurred between the basal and the contrast-enhanced acquisitions.
CONCLUSIONS: Caution should be always exercised in patients with suspected gastrointestinal perforation, especially if caused by ingested foreign bodies. A high degree of suspicion and a CT scan may prevent delays in the diagnosis and clinical management of these patients.
Keywords: Eating, Foreign Bodies, Intestinal Perforation, Tomography Scanners, X-Ray Computed, Aged, Deglutition, Ileal Diseases, Ileum, Laparotomy, Tomography, X-Ray Computed
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