Small-Bowel Perforation Caused By A Swallowed Chicken Bone – A Case Report
2012
Introduction: Ingesting a foreign body is not an uncommon occurrence and most foreign objects pass uninterrupted through the gastrointestinal tract without any complications. Bowel perforation leading to acute abdomen requiring surgical treatment is seen in very few cases. Case presentation: We are presenting a case with acute abdomen caused by accidentally ingesting a part of chicken bone. A 61-year-old male was presented in the surgical emergency clinic with abdominal pain, nausea, and anorexia. Upon physical examination, a distended and diffusely tender abdomen with right lower abdomen rebound was revealed. Laparotomy was performed in general anesthesia on the day the patient was admitted. Intra-operative findings revealed diffuse purulent peritonitis.Discussion: Foreign bodies accidentally ingested mostly pass through the gastrointestinal tract without any consequences. The most common objects are dentures, fish bones, chicken bones, toothpicks, and cocktail sticks. A definitive preoperative history of foreign body ingestion is uncertain. During laparotomy we found diffuse purulent peritonitis. A tiny sharppointed object was found penetrating the inflamed portion of the distal ileum. We decided to do resection of the distal ileum with primary anastomosis. The postoperative treatment went well. Conclusion: Intestinal perforation by a chicken bone is rare and most often affects the left colon or distal ileum. The lack of history of ingestion and of detection of chicken bones preoperatively is of interest to be considered in the differential diagnosis of acute abdomen, which in this case was treated surgically.
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