CT Findings in Gastrointestinal Perforation by Ingested Fish Bones

Gonzalez, Jorge Gomez; González, Ricardo Rodríguez; Patiño, J Villacorta; García, Antonio Torres; Alvarez, Cristina Pimentel; Pedrosa, C. S.

doi:10.1097/00004728-198801000-00016

Cited by 56 publications

(28 citation statements)

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“…The reason is the large variety of sites of perforation, the frequent lack of awareness of having ingested a foreign body [7] and the various clinical manifestations of perforation [1,2,8], including abdominal pain, nausea, vomiting, fever, peritonitis, localized abscess formation, inflammatory mass, fistulas-including colorectal and colovesical fistulas [4], mechanical bowel obstruction and gastrointestinal hemorrhage. Rare complications secondary to the perforation are septicemia, portal pyemia or pyogenic abscess, enterovascular fistulas and even endocarditis [1].…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, it is unusual to see a pneumoperitoneum on a simple abdominal film in cases of perforation caused by ingested foreign bodies; the reason is that perforation is usually caused by progressive impaction of the object in the intestinal wall; this allows it to be covered with fibrin and adjacent loops and prevents the passage of extensive quantities of fluid or gas into the peritoneal cavity [1]. No free pneumoperitoneum was visible in the seven reported cases A few years ago, before the advent and development of SCT and more recently of MDCT, there was a competition between conventional CT and ultrasonography [3,6,7,9] to establish the diagnosis of perforation due to foreign body ingestion, and the performance was enhanced by the association of the two modalities [6]. Conventional CT was able to detect the calcified content of ingested foreign body and the presence of very small quantities of extraluminal gas, but its performance was impaired by a limited spatial resolution, the discontinuity of the sections and the very poor quality of multiplanar reconstructions.…”

Section: Discussionmentioning

confidence: 99%

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Spiral CT and multidetector-row CT diagnosis of perforation of the small intestine caused by ingested foreign bodies

2004

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The aim of this retrospective study was to emphasize the performances of spiral CT (HCT) and multidetector-row CT (MDCT) as very effective imaging modalities for the diagnosis of intestinal perforations caused by calcified alimentary foreign bodies. Eight sites of perforations of the ileum by ingested foreign bodies were found in seven patients--one patient presenting with two separate sites of perforation. The diagnosis was successfully made by HCT in four patients and MDCT in the remaining three. Involuntarily and generally unconsciously ingested chicken and fish bones were the implicated calcified foreign bodies. The acute clinical presentations were nonspecific, mimicking more common acute abdominal conditions. A thickened intestinal segment (7/8 sites) with localized pneumoperitoneum (4/8 sites), surrounded by fatty infiltration (4/8 sites) and associated with already present or developing obstruction or sub-obstruction (5/7 patients) were the most common CT signs, but the definite diagnosis was clearly made by the identification of the calcified foreign bodies (7/7 patients). In each patient, this identification was only possible thanks to the scrupulous analysis of very thin overlapping reconstructions obtained not only in the perforation sites (6/8 sites), but also through the entire abdomen (2/8 sites). Our report emphasizes the high performances of CTA and MDCT in identifying intestinal perforation caused by calcified alimentary foreign bodies. Moreover, the high specificity of the CT diagnosis made it possible to avoid surgerical exploration in three patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Spiral CT and multidetector-row CT diagnosis of perforation of the small intestine caused by ingested foreign bodies

2004

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“…[1][2][3][4][5][6][7] It is important to identify the presence, location, and cause of the perforation correctly for appropriate management and surgical planning. The clinical diagnosis of the site of GI tract perforation is difficult as the symptoms may be non-specific.…”

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confidence: 99%

Evolution of imaging for abdominal perforation

Singh

Steward

Booth

et al. 2010

annals

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INTRODUCTION Gastrointestinal (GI) perforation is a common surgical presentation. In recent years, computed tomography (CT) has been shown to be accurate for predicting the site of GI perforation, and has become the investigation of choice. However the signs may be subtle or only indirectly related to the site or aetiology of perforation. SUBJECTS AND METHODS A MEDLINE and PubMed search was performed for journals before June 2009 with MeSH major terms 'CT' and 'perforation'. Non-English speaking literature was excluded. RESULTS Examples of GI perforation of various aetiologies are reviewed (inflammatory, neoplastic, traumatic and iatrogenic) high-lighting characteristic CT appearances as well as pitfalls in diagnosis. Features of perforation include the presence of free gas or fluid within the supra-and/or inframesocolic compartments, segmental bowel wall thickening, bowel wall discontinuity, stranding of the mesenteric fat and abscess formation. CONCLUSIONS These differentiating features facilitate accurate multidisciplinary pre-operative evaluation, necessary to plan patient management and potential surgical approach.

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“…Yet there is still the danger of perforation of the gut at the ileocecal valve and sigmoid colon. This occurs in less than 1% of the cases; it coincides with symptoms such as abdominal pain, fever, nausea and vomiting [2,10]. Although most foreign bodies pass through the intestinal tract in 2 to 12 days, the patient should be referred to a medical specialist, as objects with sharp edges may require elective removal.…”

Section: Ingestionmentioning

confidence: 99%

“…Es besteht jedoch die Gefahr einer Darmperforation an der Ileozäkalklappe und im Sigmoid. Dies geschieht in 1% der Fälle und geht mit Bauchschmerzen, Fieber, Übelkeit und Erbrechen einher [2,10]. Die meisten Fremdkörper passieren den Magen-DarmTrakt in 2 bis 12 Tagen.…”

Section: Verschluckenunclassified

Orthodontic Archwire in the Nasal Cavity. A Case Report

2009

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We present the unusual case of a patient who lost an orthodontic archwire after having, via manipulation, detached it from the brackets. It was only on a routine radiograph at the end of treatment that the archwire was found in the patient's nasal cavity, where it had failed to cause any symptoms! We discuss the treatment following the inhalation and ingestion of foreign bodies in orthodontics, as well as their prevention.

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CT Findings in Gastrointestinal Perforation by Ingested Fish Bones

Cited by 56 publications

References 0 publications

Spiral CT and multidetector-row CT diagnosis of perforation of the small intestine caused by ingested foreign bodies

Spiral CT and multidetector-row CT diagnosis of perforation of the small intestine caused by ingested foreign bodies

Evolution of imaging for abdominal perforation

Orthodontic Archwire in the Nasal Cavity. A Case Report

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