Gastrointestinal perforations by ingested foreign bodies: A preoperative diagnostic flowchart-based experience. A case series report

An unexpected cause of abdominal pain: a case report of a toothpick in the liver successfully treated with gastroendoscopy

Foreign body ingestion is a frequent occurrence in emergency departments, with most cases resolving without complications. However, sharp objects like toothpicks carry a higher risk of serious outcomes, including perforation and abscess formation. In this case, we are presenting a 62-year-old male patient who arrived at the emergency department with severe right upper quadrant abdominal pain and fever. Despite the absence of signs of gastrointestinal perforation or peritonitis, imaging revealed a toothpick penetrating both the stomach and liver, with no evidence of abscess formation. The toothpick was successfully removed using a gastroscopic approach. This case highlights an unusual condition where a foreign body migrated to the liver, yet the patient was successfully managed through a non-surgical, minimally invasive approach. Early diagnosis and minimally invasive intervention can lead to favorable outcomes without the need for invasive procedures.

Foreign Body Perforating the Descending Colon Incidentally Detected on 18 F-FDG PET/CT

ABSTRACT

A 78-year-old woman was diagnosed having unresectable tongue cancer 6 months ago, for which she received radiation therapy. She was on enteral nutrition for more than 2 months due to dysphagia and underwent an 18 F-FDG PET/CT for restaging. The images showed uptake in a left cervical node. In addition, there was a focal uptake in the descending colon corresponding to a foreign body in its anterior wall, which was removed by colonoscopy.

Ileal perforation peritonitis secondary to accidental ingestion of a chicken bone: A case report

INTRODUCTION AND IMPORTANCE

Ileal perforation is a rare but serious condition that can arise from accidental ingestion of foreign objects. This report discusses an unusual case of ileal perforation peritonitis caused by ingestion of a chicken bone.

CASE PRESENTATION

A 60-year-old male presented with acute generalized abdominal pain, fever, nausea, and vomiting for three days. A physical examination revealed signs of peritonitis. Imaging results were unremarkable. Emergency laparotomy revealed perforation in the ileum caused by the chicken bone. The perforated segment was resected, and primary anastomosis was performed.

CLINICAL DISCUSSION

Ingestion of foreign bodies, although common, rarely leads to gastrointestinal perforations. Among these foreign bodies, chicken bones are rarely reported, making the diagnosis challenging because of nonspecific symptoms and low clinical suspicion. Prompt surgical intervention is crucial for managing complications such as peritonitis and sepsis.

CONCLUSION

This case highlights the importance of considering foreign body ingestion in the differential diagnosis of acute abdominal pain, particularly in patients without an obvious cause of peritonitis. Early detection and timely surgical intervention are essential to improve patient outcomes.

Incidental Finding of a Fish Bone Perforation in the Pylorus Mimicking Acute Cholecystitis

We present a case of a 43-year-old man with Crohn's disease who presented with epigastric and right upper quadrant abdominal pain, initially suspected to be acute cholecystitis or a Crohn's flare-up. CT revealed a curvilinear, hyperdense foreign body adjacent to the duodenum, concerning micro-perforation. Endoscopic examination confirmed findings of a 3 cm fish bone lodged in the pylorus. Endoscopic extraction was successful without significant mucosal damage, and the patient recovered well postoperatively. This case highlights the rarity of pyloric perforation secondary to fish bone ingestion and highlights the importance of considering this diagnosis in patients presenting with unexplained acute abdominal pain, as prompt recognition and intervention are essential for favorable outcomes.