Gradual Colonic Impaction of a Chicken Bone Associated with Inflammatory Pseudotumor Formation and Nonocclusive Colon Ischemia. (11th February 2014)

• Record Type: Journal Article
• Authors: Fosi, Stefania; Altobelli, Simone; Bindi, Alessio; Villa, Massimo; De Sanctis, Flavio; Montuori, Mauro; Ricciardi, Edoardo; Rossi, Piero; Petrella, Giuseppe; Simonetti, Giovanni
• Other Names: Barron B. J. Academic Editor.; Low V. Academic Editor.
• Is Part Of: Case reports in radiology. Volume 2014(2014)
• Publication Date: 2014-02-11
• Subjects: Radiology -- Periodicals; Radiology -- Case studies -- Periodicals; Medical radiology -- Periodicals; Radiology; Radiology; Medical radiology; Periodicals; Electronic journals; Case studies; Periodicals; 616.0757
• DOI: 10.1155/2014/215465
• Languages: English
• ISSNs: 2090-6862

Abstract

Abstract : Foreign body (FB) ingestion is a common clinical problem and most FBs pass through the gastrointestinal tract without the need for intervention. A wide spectrum of clinical presentations may be possible and these can be either acute or chronic. We present a case of an 83-year-old woman featuring insidious abdominal discomfort who was hospitalized in our institution due to worsening symptoms. She underwent contrast-enhanced computed tomography (CT) evaluation which showed the presence of a significant parietal thickening of the transverse and descending colon, a mesenteric loose tissue imbibition, venous engorgement, and no filling defect of visceral arteries, suggesting a condition of nonocclusive colon ischemia. A hyperdense FB was identified in the sigma and was associated with a small pseudotumoral mass. The patient underwent surgical exploration which confirmed the hypoperfusional state of the colon, showing the presence of a chicken bone perforating the sigma and lying in the context of a pseudotumoral mass. Our experience shows how contrast-enhanced CT is feasible and can be strongly recommended as a first-line imaging tool on suspicion of colon ischemia and also how it can easily identify the underlying cause, in our case a FB sealed perforation of the sigma with pseudotumoral mass formation.