ObjectiveTo identify the computed tomography findings suggestive of intestinal
perforation by an ingested foreign body.Materials and MethodsThis was a retrospective study of four cases of surgically proven intestinal
perforation by a foreign body, comparing the computed tomography findings
with those described in the literature.ResultsNone of the patients reported having ingested a foreign body, all were over
60 years of age, three of the four patients used a dental prosthesis, and
all of the foreign bodies were elongated and sharp. In all four patients,
there were findings indicative of acute abdomen. None of the foreign bodies
were identified on conventional X-rays. The computed tomography findings
suggestive of perforation were thickening of the intestinal walls (in all
four cases), increased density of mesenteric fat (in all four cases),
identification of the foreign body passing through the intestinal wall (in
three cases), and gas in the peritoneal cavity (in one case).ConclusionIn cases of foreign body ingestion, intestinal perforation is more common
when the foreign body is elongated and sharp. Although patients typically do
not report having ingested such foreign bodies, the scenario should be
suspected in elderly individuals who use dental prostheses. A computed
tomography scan can detect foreign bodies, locate perforations, and guide
treatment. The findings that suggest perforation are thickening of the
intestinal walls, increased mesenteric fat density, and, less frequently,
gas in the peritoneal cavity, often restricted to the point of
perforation.
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