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Radiological diagnosis of a small bowel perforation secondary to toothpick ingestion

Identifieur interne : 002751 ( Main/Exploration ); précédent : 002750; suivant : 002752

Radiological diagnosis of a small bowel perforation secondary to toothpick ingestion

Auteurs : David Mark [Royaume-Uni] ; Kathryn Ferris [Royaume-Uni] ; Gareth Martel [Royaume-Uni] ; Keith Mulholland [Royaume-Uni]

Source :

RBID : ISTEX:398C1C3678F3F0A5E356925BF5BB5AEF9253DBFB

English descriptors

Abstract

A 77-year-old edentulous man presented to the accident and emergency department with a sudden onset of sharp right-sided abdominal pain. The patient reported a change in his bowel habit with constipation over a 6 month period but did not report any significant choking event or ingestion of a foreign body in the preceding months. On examination the patient was maximally tender with guarding over McBurneys point. CT scan showed an abnormal segment of distal ileum with a 3 cm high attenuation focus which had penetrated the bowel wall. At laparotomy the patient was found to have a perforation of his distal ileum caused by an ingested toothpick. Patients wearing dental plates or dentures are at higher risk of toothpick ingestion due to impaired palatal sensation. CT scanning, in the appropriate setting, may aid diagnosis and lower operator risk of sharp related injury at the time of operation.

Url:
DOI: 10.1136/bcr-2013-009869


Affiliations:


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Le document en format XML

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<div type="abstract">A 77-year-old edentulous man presented to the accident and emergency department with a sudden onset of sharp right-sided abdominal pain. The patient reported a change in his bowel habit with constipation over a 6 month period but did not report any significant choking event or ingestion of a foreign body in the preceding months. On examination the patient was maximally tender with guarding over McBurneys point. CT scan showed an abnormal segment of distal ileum with a 3 cm high attenuation focus which had penetrated the bowel wall. At laparotomy the patient was found to have a perforation of his distal ileum caused by an ingested toothpick. Patients wearing dental plates or dentures are at higher risk of toothpick ingestion due to impaired palatal sensation. CT scanning, in the appropriate setting, may aid diagnosis and lower operator risk of sharp related injury at the time of operation.</div>
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