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Case Reports
. 2021 Oct 28:9:2050313X211056414.
doi: 10.1177/2050313X211056414. eCollection 2021.

Foreign body ingestion-related peritonitis in an elderly peritoneal dialysis patient

Taghavi Maxime  1 , Bellavia Salvatore  2 , Thibaut Véronique  1   2   3   4 , De Pelsemaeker Marie-Caroline  4 , Mesquita Maria do Carmo Filomena  1 , Godon Eric  2
Affiliations
Case Reports

Foreign body ingestion-related peritonitis in an elderly peritoneal dialysis patient

Taghavi Maxime et al. SAGE Open Med Case Rep. .

Erratum in

Abstract

Among peritoneal dialysis patients, peritoneal dialysis-related peritonitis is a well-known complication, but it can also be non-peritoneal dialysis-related (e.g. ruptured appendix). Ileal perforation by foreign bodies such as blister pill packs can be seen in the emergency room. Differentiating this from peritoneal dialysis-related peritonitis can be difficult, since they can have both identical presentations. Computed tomography can be of value in detecting abscess, thickening of the digestive wall or adhesions, and exclude other causes of intra-abdominal sepsis. Because of the aging population, ingestion of foreign body can be expected to rise. We therefore recommend that blister pill packs should not be divided into single-dose pieces, and we invite elderly patient's entourage to check medication administration. Furthermore, manufacturing efforts are highly recommended to improve blister pill pack's design, to avoid accidental ingestion. We report the case of an elderly peritoneal dialysis patient who presented with peritonitis due to ileal perforation because of blister pill pack ingestion.

Keywords: Peritonitis; blister packs; elderly patients; intestinal perforation; peritoneal dialysis.

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Conflict of interest statement

Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
(a) Non-enhanced CT scan (coronal plane) showing pneumoperitoneum (extradigestive gas) with locoregional fat stranding (yellow arrow) foreign body responsible for the digestive perforation (blue arrow). (b) Non-enhanced CT scan (sagittal plane) showing the foreign body responsible for perforation. We recognize the drug blister with its lidding seal of aluminum foil (blue arrow). (c) Non-enhanced CT scan (axial plane) showing the empty blister with its lidding seal of aluminum foil and figure. (d) Drug blister.
Figure 2.
Figure 2.
(a) Macroscopic view. We received a partial ileal resection. Macroscopically, we identified a perforation of ileum wall due to a foreign body, a blister. (b) Microscopic view (×0.6). Microscopically, ileum wall was one side ulcerated and the other perforated (arrows). It shows where the blister touched ileum wall. (c) Microscopic view (×2.6). Ileum wall shows necrosis and perforation (arrow).
See this image and copyright information in PMC

References

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