Unusual clinical course, Management of emergency care
Va-Kei Kok, Pao-Chien Chen, Ching-Ching Lee, Sho-Jiun Chou
CaseRepClinPractRev 2005; 6:48-51
Available online: 2005-01-02
Background: Gastrointestinal (GI) tract perforation causing acute abdominal pain is quite commonly seen in the emergency room (ER), although accurate diagnosis of bamboo- material perforation of the
small bowel can be difficult. The manifestations of bamboo- splinter perforation of the bowel can vary from mild, nonspecific GI distress to an acute abdomen. According to the literatures reviewed, the correct diagnosis for many cases of gastrointestinal perforation is typically made following laparotomy.
Case report: We report our experience with a healthy patient for whom ingestion of a bamboo splinter was associated with substantial abdominal pain. Computer tomography (CT) scanning suggested
that a non-metal foreign body had penetrated in the bowel wall. Laparotomy confirmed terminal ileum perforation by a fine bamboo splinter.
Conclusion: This report describes and illustrates a case of small- bowel perforation secondary to the ingestion of a bamboo splinter. We emphasize the potential for differing diagnoses for such a condition,
and the role of CT scan in evaluating such cases. While routine plain abdominal roentgenography failed to identify the perforating agent and while such imagery may lead to an incorrect diagnosis
for cases of acute abdominal pain, CT scanning plays a critical role for preoperative diagnosis for some unusual examples of acute abdominal pain.
Keywords: Foreign body ingestion, small bowel perforation, computed tomography demonstration