Gastrointestinal Tract Perforations Due to Ingested Foreign Bodies; A review of 21 c ases

Aim : To study the etiology, presentation and complications of Gastrointestinal tract (GIT) perforations due to ingestion of foreign bodies. Methods: A retrospective review of 21 patients with perforations in the GIT due to foreign body ingestion was done in the Department of General Surgery Sher-i-Kashmir Institute of Medical Sciences Srinagar (SKIMS) from January 2002 to December 2011.Data was reviewed in terms of the type and nature of the foreign objects, mode of entry into the gastrointestinal (GIT), preoperative diagnosis, perforation site, and treatment received. Results: 66.6% of patients were males with age ranging from 7 to 82 years and a median age of 65 years. A definitive preoperative history of foreign body ingestion was obtained in 4 (19.04%) of the 21 patients. The mean time from ingestion to presentation was 9.3 days. The various foreign bodies recovered were chicken bones in 10 (47 %), fish bones in 7 (33.33%), toothpick in 2 (9.5%) and metallic staple in 2 (9.5%) patients. A preoperative diagnosis of acute abdomen of uncertain origin was given in 12 (57.14%) of the 21 patients. Site of involvement in decreasing order of frequency was ileum in 14 (66.6%), colon in 5 (23.8%) and jejunum in 2 (9.5%) patients. Commonest surgery done on these patients was emergency laparotomy with primary repair in 11 (52.38%) and intestinal resection with ileostomy in 10 (47.6%) patients. Complication in terms of surgical site infection was seen in 3 (14.28%) patients and 2 (9.5%) deaths were recorded. Conclusion: Dietary foreign body is the most commonly ingested object giving rise to GIT perforation. Treatment consists of surgery and antibiotics. Patients are rarely aware of foreign body ingestion and a high index of suspicion is required to make a diagnosis of ingested foreign body in all acute