Jejunal perforation due to ingested buffalo bone mimicking acute appendicitis. (December 2016)

• Record Type: Journal Article
• Authors: Yadav, Ajay; Malla, Gyanendra; Deo, Kunal; Giri, Saroj; Bhattarai, Bishnu; Adhikary, Shailesh
• Is Part Of: BMC research notes. Volume 9:Number 1(2016)
• Page Start: 1
• Page End: 3
• Publication Date: 2016-12
• Subjects: Local peritonitis -- Jejunum perforation -- Foreign body -- Buffalo bone -- Case report; Medicine -- Periodicals; Biology -- Periodicals; 610.5
• DOI: 10.1186/s13104-016-2127-y
• Languages: English
• ISSNs: 1756-0500

Abstract

Abstract Background Foreign body ingestion is seen quite frequently in clinical practice, intestinal perforation due to this is rare. The foreign body often mimics another cause of acute abdomen and requires an emergency surgical intervention. The majority of patients do not recall ingesting sharp foreign bodies. Case presentation We report an interesting case of a fifty five year-old man who presented with pain in the right iliac fossa with localised tenderness which was clinically diagnosed as acute appendicitis. During the operation, the presence of purulent collection and the inflamed bowel with flakes raised suspicion of bowel perforation. The assessment of the proximal small bowel revealed two small perforations in the jejunum. A hard, bony and sharp object was extracted and the perforations were closed. Post-operative recovery was uneventful. Detailed food history was taken following the recovery of the patient from surgery. It revealed the history ingestion of home prepared buffalo meat. The extracted object was identified as 'buffalo bone' by the patient and the care taker of the patient. The jejunum was perforated by the ingested buffalo bone causing local peritonitis in right iliac fossa. Conclusion Intestinal perforation by ingested foreign bodies should be suspected in acute abdomen. It requires a high degree of suspicion and awareness on the part of the clinician.