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 Cicero, Simona Caloggero, Marco Cavallaro, Luciano Frosina, Carmela Visalli, Velio Ascenti, Alfredo Blandino, Silvio Mazziotti
Section of Radiological Sciences, Department of Biomedical Sciences and Morphological and Functional Imaging, University of Messina, Policlinico “G. Martino”, Messina, Italy
Am J Case Rep 2019; 20:635-639
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