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Rectal perforation by inadvertent ingestion of a blister pack: A case report and review of literature

World Journal of Clinical Cases 2018年第10期6卷 384-392页

作者： Francesco Fleres Antonio Ieni Edoardo Saladino Giuseppe Speciale Michele Aspromonte Antonio Cannaò Antonio Macrì Department of Human Pathology of the Adult and Evolutive Age "Gaetano Barresi" Section of General Surgery University of Messina Department of Human Pathology of the Adult and Evolutive Age "Gaetano Barresi" Section of Anatomic Pathology University of Messina General and Oncologic Surgery Unit Clinica Cappellani-GIOMI Messina University Medical School Hospital peritoneal surface malignancy and soft tissue sarcoma program Messina University Medical School Hospital

The accidental ingestion of a foreign body(FB) is a relatively common condition. In the present study, we report a peculiar case of rectal perforation, the first to our knowledge, caused by the inadvertent ingestion of a blister pill pack. The aim of this report is to illustrate the difficulties of the case from a diagnostic and therapeutic viewpoint as well as its unusual presentation. A 75-year-old woman, mentally impaired, arrived at our emergency department in critical condition. The computed tomography scan revealed a substantial abdominopelvic peritoneal effusion and free perigastric air. The patient was therefore submitted to an urgent exploratory laparotomy; a 2-cm long, full-thickness lesion was identified in the anterior distal part of the intraperitoneal rectum. Hence, we performed a Hartmann's procedure. Because of her critical condition, the patient was eventually transferred to the Intensive Care Unit, where she died after 10 d, showing no surgical complication. The ingestion of FBs is usually treated with observation or endoscopic removal. Less than 1% of FBs are likely to cause an intestinal perforation. The intestinal perforation resulting from the unintentional ingestion of an FB is often a difficult challenge when it comes to treatment, due to its late diagnosis and the patients' deteriorated clinical condition.

关键词： Foreign body Acute abdomen syndrome Ingestion Rectal perforation Blister pill pack

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