Press-through packages (PTPs) are regularly used to enclose drugs, and are increasingly seen in cases of ingested foreign bodies in the alimentary tract. Most cases of ingested PTP-induced bowel perforation are difficult to diagnose. We herein present a case of preoperative computed tomography (CT) demonstration showing ingested PTPinduced small intestinal perforation. An index of high suspicion and early exact diagnosis by high-resolution CT are requisite to avoid deterioration of the patients' condition and to improve outcome. Journal of Gastroenterology and Hepatology Research 2157 Fujikawa T et al . CT images of ingested PTPs causing intestinal perforationFigures 1 (A) High-resolution plain CT scan of the abdomen demonstrated free air around the small intestine at the right lower abdomen and a round low-density shadow with an internal high-density part inside the small intestine. (B) Another similar low-density shadow accompanied by linear high-density parts was also seen. (C,D) On emergency laparotomy, a laceration of the middle ileum due to a pressthrough package (PHP) was found (a yellow arrow). Extraction of two PHPs followed by partial resection of the lacerated ileum was performed. CONFLICT OF INTERESTThe authors declare that they do not have conflict of interests. Peer reviewer: REFERENCES
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