Perforation of midpart of ileum caused by entrapment of a large, wide foreign body

Abstract

SUMMARY
We report the case of a 54-year old male patient with a long
history of irritable bowel syndrome who unknowingly swallowed
a foreign body (wire) while having roast, lamb as a
meal. The wire body ultimately perforated the midpart of
the ileum over a period of one month. Gastroenteritis and
irritable bowel dysfunction were sequentially considered as
possible diagnoses. A plain radiograph of the abdomen in
the erect position revealed the foreign body, a metal curved
wire about 6-8 cm long, and 2-3 cm wide located in the upper-
midpart of the abdomen, with no signs of gastrointestinal
perforation. Upper GI endoscopy until the third portion
of the duodenum did not reveal the foreign object. Surgical
intervention revealed free perforation of the midpart
of the ileum in two sites caused by the points of the curved
wire, which was removed. In the case reported, the long,
wide object passed through the stomach and the bowel perforation
clinical signs were mild, starting over a period of
long time after the initial event of the accidental swallowing
of the wire object.
Key words: foreign body, small-bowel perforation, endoscopy,
x-rays, surgical exploration.