Ileum perforation due to accidental chicken bone ingestion a rare cause of the acute abdomen

• Main Authors: Doklestić Krstina S., Karamarković Aleksandar R.
• Format: Article
• Language: English
• Published: Association of medical doctors Sanamed Novi Pazar 2012-03-01
• Series: Sanamed
• Subjects: small-bowel perforation; chicken wishbone; peritonitis
• Online Access: http://sanamed.rs/sanamed_pdf/sanamed_7_1/Krstina_Doklestic.pdf

Ingestion of foreign bodies is not an uncommon occurrence, but most of them will pass through the gastrointestinal tract without consequences. Complication such as perforation is rare. We present a case of small bowel perforation secondary to the accidental ingestion of a chicken bone. The patient presented with abdominal pain, constipation and vomiting. Clinical examination confirmed generalized abdominal tenderness and rebound tenderness. Abdominal radiography showed multiple dilated loops of small bowel, and abdominal ultrasound (US) showed inflammatory changes on small bowel loops, with free fluid and fluid collection around intestinal loops. The patient underwent an emergency laparotomy. Intra operative findings revealed diffuse fibro purulent peritonitis with abscess between central small bowels loops. At about 60 cm from Bauchini valve we found a perforation of ileum at the anti-mesenteric site caused by a sharp chicken wishbone. The patient was treated with resection of the ileum segment (10 cm) and primary end-to-end anastomosis. Even that intestinal perforation by a foreign body is rare, physicians should consider possibility of intestinal perforation by a foreign body in the differential diagnosis of acute abdomen in patients presenting with abdominal pain.