González-Chávez MA, Salas-García AG, Grajeda-Gómez A, Robles-Menchero MJ, Martínez-Miranda CA, Huacuja-Blanco RR, Díaz-Girón-Gidi A, Correa-Rovelo JM, Martínez-Garza PA, Alessio Robles-Landa LP

Language: Spanish
References: 20
Page: 36-41
PDF size: 359.40 Kb.

ABSTRACT

The accidental ingestion of foreign bodies is a common problem. The majority of the ingested objects pass through the gastrointestinal tract unnoticed and only 1% of the cases might cause complications such as acute abdomen secondary to an intestinal perforation. This type of complication commonly occurs in anatomic structures such as the pylorus, distal ileum, ileocecal valve or rectosigmoid union. There are different clinical scenarios depending on the injured anatomical site, engagement of the adjacent organs and the time of evolution. It is a surgical emergency which requires a quick diagnosis and an immediate surgical treatment, it might be thought that for the vast majority of the patients, the best surgical approach is the exploratory laparotomy, which allows complete assessment of the abdominal cavity. However, the laparoscopic approach has gained place for this type of pathology in particular. An initial control of the perforation can be achieved through primary closure or resection of the affected segment and anastomosis. In the following paper, a clinical case of intestinal perforation by a chicken bone treated at Médica Sur Hospital is presented: A 56 year old man arrives to the emergency room with colicky type abdominal pain localized in hypogastric region and irradiated to the whole abdomen accompanied by nausea. After having consulted with the General Surgery Service, the diagnosis of acute abdomen secondary to sigmoid perforation by a foreign body has made.

REFERENCES

1. Rodríguez J, Farrés R, Codina A, Olivet F, Pont Valles J, Gironés J, Roig J. Perforaciones Intestinales causadas por cuerpos extraños. Cirugía Española 2001; 69: 504-6.

2. Adulf H. Anal pain secondary to swallowed bone. Ghana Medical Journal 2006; 40(1): 31-2.

3. Rodas J, Frachi F, Gutierrez T. Perforación de colon sigmoides por ingestión de cuerpo extraño. Rev Cir Parag 2012; 36(2): 23-4.

4. Rojas E. Cuerpos extraños en el tracto digestivo. Manual de Urgencias en MI. Ediciones Acta Médica; 2007.

5. Ochoa LM, González MD, Caparrós R, Narbona B. Absceso subfrénico tras ingestión de cuerpo extraño. Tratamiento quirúrgico. Cir Esp 1999; 66: 361-2.

6. Son Chung Y, Woo Chung Y, Mi Yoon S, Kim M, Oh Kim K, Hee Park C, Hahn T (n. d.). Toothpick impaction with sigmoid colon pseudodiverticulum formation successfully treated colonoscopy. World J Gastroenterol 2008; 14(6): 948-50.

7. Webb WA. Management of foreign bodies of the upper gastrointestinal tract. Gastroenterology 1988; 94: 204-16

8. Barragán C, Rueda J, Espitia E, Uriza L, Rosselli D. Perforación intestinal por espina de pescado, revisión de la literatura científica y presentación de dos casos. Revista Colombiana de Cirugía 2012; 27: 79-84.

9. Arif Hussain Sarmast, Hakim Irfan Showkat, Asim Mushtaq Patloo, Fazl Q Parray, Rubina Lone, Khurshid Alam Wani. Gastrointestinal Tract Perforations Due to Ingested Foreign Bodies; A review of 21 cases. BJMP 2012; 5(3): a529.

10. Sandeep Joglekar, Iqbal Rajput, Sachin Kamat, Sarah Downey. Sigmoid perforation caused by an ingested chicken bone presenting as right iliac fossa pain mimicking appendicitis: a case report. Journal of Medical Case Reports 2009; 3: 7385.

11. Sheng Der Hsu, De Chuan Chan, Yao Chi Liu. Small bowel perforation caused by fish bone. World J Gastroenterol 2005; 11(12): 1884-5.

12. Rasheed A, Deshpande V, Slanetz P. Colonic Perforation by Ingested Chicken Bone. Am J Roentgenol 2001: 176.

13. Read TE, Jacono F, Prakash C. Coloenteric fistula from chicken bone perforation of the sigmoid colon. Surgery 1999; 125: 345-56.

14. Imuta M, Awai K, Nakayama Y, Murata Y, Asao C, Matsukawa T, et al. Multidetector CT findings suggesting a perforation site in the gastrointestinal tract: Analysis in surgically confirmed 155 patients. Radiat Med 2007; 25(3); 113-8.

15. Goh BK, Chow PK, Quah HM, Ong HS, Eu KW, Ooi LL, et al. Perforation of the gastrointestinal tract secondary to ingestion of foreign bodies. World J Surg 2006; 30: 372-7.

16. Ordoñez CA, Puyana JC. Management of peritonitis in the critically ill patient. Surg Clin North Am 2006; 86: 1323-49.

17. Alonso-Gomez S, Rubio-Gonzalez E, Donat-Garrido M, Lopez- Espadas M, Solís-Herruzo J, Moreno-Gonzalez E. Sigmoid colon perforation due to a foreign body ingestion. Rev Esp Enferm Dig 2012; 104: 90-1.

18. Rodríguez-Hermosa JI, Codina-Cazador A, Sirvent JM, Martín A, Girones J, Garsot E. Surgically treated perforations of the gastrointestinal tract caused by ingested foreign bodies. Colorectal Dis 2008; 10: 701-7.

19. Myers E, Hurley M, O’Sullivan GC. Laparoscopic peritoneal lavage for generalized peritonitis due to perforated diverticulitis. Br J Surg 2008; 95: 97-101.

20. Frederic B, Karine P, Caroline M, Emergency laparoscopic management of perforated sigmoid diverticulitis: A promising alternative to more radical procedures. J Am Coll Surg 2008; 206: 654-7.