A fluid-filled condom causing intestinal obstruction: nonsurgical therapy of an ileus by ultrasound-guided transabdominal tapping

Abstract

Ingested foreign bodies are rare causes of intestinal obstruction in the adult. Condoms, if swallowed, are usually filled with drugs and found in body packers as a vehicle for drug smuggling. We report the case of 31-year-old male who presented with symptoms and signs of intestinal obstruction. He had swallowed a fluid-filled condom the day before. Ultrasonography of the abdomen revealed a fluid-filled foreign body within the small bowel. Due to radiological signs of an ileus and due to the fact that the patient's symptoms did not resolve after spasmolytic therapy the condom was tapped transcutaneously under ultrasonographical guidance. This procedure immediately relieved his symptoms. The further course was uneventful.

PIP: A 31-year old man presented to the emergency department complaining of abdominal pain which had begun 2 hours earlier. The pain was located mainly around the umbilicus, did not radiate, and was of colicky character, coming and going in 30-minute intervals. The patient had vomited several times and had had the most recent bowel movement on that day. He admitted to having swallowed a water-filled condom about 20 hours earlier. Drug couriers sometimes fill condoms with drugs and swallow them for clandestine transport. The patient manifested signs and symptoms consistent of intestinal obstruction, although ingested foreign objects rarely obstruct the adult intestine. Ultrasonography of the abdomen revealed a fluid-filled foreign body within the small bowel. Due to radiological signs of an ileus and because the patient's symptoms failed to resolve after spasmolytic therapy, the condom was tapped transcutaneously under ultrasonographical guidance. The procedure immediately relieved the patient's symptoms and his further course was uneventful.