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Case Reports
. 2025 Jan 20;17(1):e77751.
doi: 10.7759/cureus.77751. eCollection 2025 Jan.

Medication Blisters: A Rare Cause of Bowel Perforation

Lachezar Lalov  1   2 , Nicolas Naccarella  1 , Jacques Rommens  1
Affiliations
Case Reports

Medication Blisters: A Rare Cause of Bowel Perforation

Lachezar Lalov et al. Cureus. .

Abstract

Foreign body ingestion is a common occurrence in vulnerable populations, predominantly at the ends of the age spectrum. While most cases are uncomplicated, some patients may require endoscopic or surgical intervention to prevent serious complications. Therefore, accurate and detailed radiological evaluation is essential for therapeutic decision-making. We present the case of an 80-year-old woman presenting with abdominal pain and radiological evidence of a foreign body in the small intestine. A conservative treatment approach was initially proposed due to the absence of complications and the hypothesis that a fishbone was the cause. However, her condition deteriorated due to bowel injury, complicated by bleeding and perforation. Multiplanar and 3D reconstructions identified the object as a medication blister located in the sigmoid colon. Urgent surgical intervention allowed for the retrieval of the object and the closure of the bowel perforation. This case highlights the importance of early, detailed, and accurate radiological evaluation to identify the characteristics of foreign bodies and guide timely intervention.

Keywords: bowel perforation; computed tomography; foreign-body; multiplanar reconstruction; volume rendering technique.

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Conflict of interest statement

Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Non-enhanced abdominal CT scan at the time of initial presentation
A spontaneously hyperdense structure (blue arrow) is seen within the ileum in the lower left quadrant. Axial view (A); coronal view (B).
Figure 2
Figure 2. Portal venous phase contrast-enhanced abdominal CT scan at the time of the first follow-up
Axial (A) and coronal (B) images showing the linear hyperdense structure (blue arrow) in the terminal ileum. Contrast extravasation is seen at the bowel wall, consistent with the source of bleeding (yellow arrow).
Figure 3
Figure 3. Portal venous phase contrast-enhanced abdominal CT scan, following the colonoscopy procedure
The previously described foreign body is situated in the sigmoid colon (A). Extensive extra-visceral gas (white arrow) is observed, suggestive of bowel perforation (B).
Figure 4
Figure 4. Multiplanar reconstruction in the plane of the foreign body
A square-shaped structure with a central round gas-density area is observed (A). Its dimensions are measured at approximately 22.5 mm (B).
Figure 5
Figure 5. Virtual rendering technique reconstruction of the foreign body
A volume rendering reconstruction revealing a thin, square-shaped structure with a central spherical gas bubble.
Figure 6
Figure 6. Perioperative photograph of the foreign body: an unopened medication blister
See this image and copyright information in PMC

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