Answer to Photo Quiz: An unusual cause of chronic abdominal symptoms

摘要

Abdominal CT showed extensive diverticulosis and a linear foreign body lodged in the wall of the sigmoid colon, with wall thickening and local infiltration. The foreign body, a chicken bone, was removed by endoscopy. The patient made a full recovery. Foreign body ingestion (FBI) is common,1 and 80% of ingested foreign bodies pass through the gastrointestinal tract without complications.2 However, these can cause obstruction, perforation or haemorrhage, or fistula formation. Perforation is experienced by only 1% of patients.3 This is usually the result of a sharp object, such as a chicken or fish bone. Perforation usually occurs at the ileocecal junction or in the sigmoid colon.2 Most patients do not provide a history of FBI. It is more common in children, the elderly, alcoholics and the mentally handicapped.1 Risk factors for FBI include the presence of dentures or sensory defects. Previous gastrointestinal surgery and diverticulosis are the most important risk factors for complications following ingestion.2