Intestinal perforation by foreign bodies

Abstract

Objective: To present our experience of patients who presented with intestinal perforation by foreign bodies to our hospital between 1980 and 1998.

Design: Retrospective study.

Setting: University hospital, Spain.

Subjects: 21 patients who presented with intestinal perforation by foreign bodies.

Main outcome measures: Size of perforations, nature of foreign bodies, clinical symptoms, radiological findings, treatment and outcome.

Results: The most common location was the terminal ileum (n = 11), followed by the rectosigmoid junction (n = 5). The objects were mainly bone fragments and toothpicks. The diagnosis was generally made at operation, and only 4 of the 21 patients had signs of pneumoperitoneum on the preoperative abdominal film. The most common treatment was simple suture of the defect.

Conclusions: Intestinal perforation by a foreign body is uncommon, and normally affects the ileocaecal and rectosigmoid regions, in which it is unusual to find pneumoperitoneum preoperatively. It must be considered in the differential diagnosis of such conditions as acute appendicitis and diverticulitis.