Peritonitis Due to Perforation of the Small Intestine by a Press-Through-Package

Clinical assessment of computed tomography for detecting ingested blister packs: A single‐center retrospective study

“… 20 The assessment of ancillary factors, such as air surrounding the tablets, is also essential. 29 , 30 , 31 Our study demonstrated that the CT detection rate for BPs with tablets was higher than for BPs without tablets. Even in cases with BPs containing tablets, the tablets could appear as high absorption findings, enabling the detection of BPs containing PP on CT scans.…”

“…Cases were considered detectable if there were indications in the medical records noted by an emergency physician, and if an experienced internal medicine doctor confirmed the presence of BPs on the CT scan, which was confirmed as a triple contrasted target sign. 29 Conversely, cases were deemed undetectable if they did not meet these criteria. CT scans were performed using a TOSHIBA Aquilion PRIME system with a tube voltage of 120 kV and a slice thickness of 5.0 mm.…”

“… 20 , 21 Computed tomography (CT) scans are effective for localizing and diagnosing complications associated with BP ingestion, 9 , 13 , 22 , 23 , 24 , 25 , 26 , 27 , 28 and they can display a triple contrasted target sign consisting of inner high, low, and slightly low‐density layers. 29 However, the detectability of BPs on CT can vary based on the material; polypropylene (PP) is not detectable, while materials like polyvinyl chloride (PVC) and polyvinylidene chloride (PVDC) are detectable. 21 , 23 , 25 These findings are based on in vitro studies that examined BP alone, rather than actual cases of human ingestion.…”

Gastric Ulcer Bleeding Caused by Press‐Through Package Mis‐Swallowing

“…Intestinal or esophageal perforation by blister-wrapped tablets has previously been reported. [2][3][4][5][6] PTP ingestion is frequently seen in older adults and in individuals with mental or visual impairment. 2,3 A case series from the Japanese literature reported 28 cases of perforation of the small intestine by a blister-wrapped tablet in PTP.…”

“…Most individuals with perforation were elderly (mean age 77). 6 The aging population, the rising number of individuals taking more than one drug, and the increasing number of drugs dispensed in blister packages may all contribute to an increase in the incidence of these accidents, although other factors may be involved. 4 A statistical analysis of 32 cases reported an apparent increase in the number of incidents between 1986 and 1993.…”