Radiological diagnosis of a small bowel perforation secondary to toothpick ingestion
Identifieur interne : 001829 ( Pmc/Checkpoint ); précédent : 001828; suivant : 001830Radiological diagnosis of a small bowel perforation secondary to toothpick ingestion
Auteurs : David Mark ; Kathryn Ferris ; Gareth Martel ; Keith MulhollandSource :
- BMJ Case Reports [ 1757-790X ] ; 2013.
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
PubMed: 23933859
PubMed Central: 3761682
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<front><journal-meta><journal-id journal-id-type="nlm-ta">BMJ Case Rep</journal-id><journal-id journal-id-type="iso-abbrev">BMJ Case Rep</journal-id><journal-id journal-id-type="hwp">casereports</journal-id><journal-id journal-id-type="publisher-id">bmjcasereports</journal-id><journal-title-group><journal-title>BMJ Case Reports</journal-title></journal-title-group><issn pub-type="epub">1757-790X</issn><publisher><publisher-name>BMJ Publishing Group</publisher-name><publisher-loc>BMA House, Tavistock Square, London, WC1H 9JR</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">23933859</article-id><article-id pub-id-type="pmc">3761682</article-id><article-id pub-id-type="publisher-id">bcr-2013-009869</article-id><article-id pub-id-type="doi">10.1136/bcr-2013-009869</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group><subj-group subj-group-type="hwp-journal-coll"><subject>1524</subject><subject>1304</subject><subject>62</subject><subject>1306</subject><subject>1327</subject><subject>149</subject><subject>1349</subject><subject>618</subject></subj-group><subj-group subj-group-type="case-report-type"><subject>Reminder of Important Clinical Lesson</subject></subj-group><subj-group subj-group-type="search-fields"><subject>Male</subject><subject>71-80 Years</subject><subject>White</subject><subject>United Kingdom</subject></subj-group><series-title>Case Report</series-title></article-categories><title-group><article-title>Radiological diagnosis of a small bowel perforation secondary to toothpick ingestion</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Mark</surname><given-names>David</given-names></name></contrib><contrib contrib-type="author"><name><surname>Ferris</surname><given-names>Kathryn</given-names></name></contrib><contrib contrib-type="author"><name><surname>Martel</surname><given-names>Gareth</given-names></name></contrib><contrib contrib-type="author"><name><surname>Mulholland</surname><given-names>Keith</given-names></name></contrib></contrib-group><aff id="af1"><label></label><addr-line>Department of General Surgery</addr-line>,<institution>Ulster Hospital</institution>,<addr-line>Belfast</addr-line>,<country>UK</country></aff><author-notes><corresp><label>Correspondence to</label> David Mark, <email>David-mark@hotmail.co.uk</email></corresp></author-notes><pub-date pub-type="collection"><year>2013</year></pub-date><pub-date pub-type="epub"><day>9</day><month>8</month><year>2013</year></pub-date><volume>2013</volume><elocation-id>bcr2013009869</elocation-id><permissions><copyright-statement>2013 BMJ Publishing Group Ltd</copyright-statement><copyright-year>2013</copyright-year></permissions><self-uri xlink:title="pdf" xlink:type="simple" xlink:href="bcr-2013-009869.pdf"></self-uri><abstract><p>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.</p></abstract></article-meta></front></pmc><affiliations><list></list><tree><noCountry><name sortKey="Ferris, Kathryn" sort="Ferris, Kathryn" uniqKey="Ferris K" first="Kathryn" last="Ferris">Kathryn Ferris</name><name sortKey="Mark, David" sort="Mark, David" uniqKey="Mark D" first="David" last="Mark">David Mark</name><name sortKey="Martel, Gareth" sort="Martel, Gareth" uniqKey="Martel G" first="Gareth" last="Martel">Gareth Martel</name><name sortKey="Mulholland, Keith" sort="Mulholland, Keith" uniqKey="Mulholland K" first="Keith" last="Mulholland">Keith Mulholland</name></noCountry></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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