Coconut leaf midrib skewer as a cause for small bowel obstruction and perforation: A case report

Foreign body ingestion is an infrequent cause of small bowel obstruction and, rarely, perforation. It is a common occurrence among pediatric patients, mentally impaired and the edentulous elderly population majority of which will pass through the gastrointestinal tract uneventfully. The likelihood o...

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Main Authors: Orlando O. Ocampo, Siegfredo R. Paloyo, Ferri P. David-Paloyo, Leonard Christopher T. Sena, Emmanuel T. Limpin, Eduardo C. Ayuste, Jr
Format: Article
Language:English
Published: Elsevier 2024-06-01
Series:Trauma Case Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S2352644024000566
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author Orlando O. Ocampo
Siegfredo R. Paloyo
Ferri P. David-Paloyo
Leonard Christopher T. Sena
Emmanuel T. Limpin
Eduardo C. Ayuste, Jr
author_facet Orlando O. Ocampo
Siegfredo R. Paloyo
Ferri P. David-Paloyo
Leonard Christopher T. Sena
Emmanuel T. Limpin
Eduardo C. Ayuste, Jr
author_sort Orlando O. Ocampo
collection DOAJ
description Foreign body ingestion is an infrequent cause of small bowel obstruction and, rarely, perforation. It is a common occurrence among pediatric patients, mentally impaired and the edentulous elderly population majority of which will pass through the gastrointestinal tract uneventfully. The likelihood of complications such as perforation, bleeding or fistula formation increases markedly particularly for sharp, stiff, and elongated objects (i.e. toothpicks, meat bones, pins, and razor blades). Diagnosis can be difficult as frequently patients are incognizant of the nature and time of ingestion. Imaging is commonly non-specific as well. We present an unusual case of a 65-year-old male who had an ileal perforation secondary to a coconut leaf midrib skewer initially presenting as small bowel obstruction. Intraoperatively, adhesions were seen in the ileum with note of the foreign body perforating two bowel loops that was not identified in preoperative imaging. This case highlights the importance of considering atypical causes of small bowel obstruction even in the background of previous surgery. Finally, early recognition, accurate diagnosis, and timely intervention are essential to improve patient outcomes and decrease mortality in such cases.
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spelling doaj-art-7dfd2b0002b94b6fb518be92188a428d2025-08-20T02:31:43ZengElsevierTrauma Case Reports2352-64402024-06-015110103310.1016/j.tcr.2024.101033Coconut leaf midrib skewer as a cause for small bowel obstruction and perforation: A case reportOrlando O. Ocampo0Siegfredo R. Paloyo1Ferri P. David-Paloyo2Leonard Christopher T. Sena3Emmanuel T. Limpin4Eduardo C. Ayuste, Jr5Department of Surgery, University of the Philippines-Philippine General Hospital, Philippines; College of Medicine, University of the Philippines-Manila, PhilippinesDepartment of Surgery, University of the Philippines-Philippine General Hospital, Philippines; College of Medicine, University of the Philippines-Manila, Philippines; Corresponding author at: Department of Surgery, University of the Philippines-Philippine General Hospital, Philippines.Department of Surgery, University of the Philippines-Philippine General Hospital, Philippines; College of Medicine, University of the Philippines-Manila, PhilippinesLucena United Doctors Hospital, PhilippinesDepartment of Surgery, University of the Philippines-Philippine General Hospital, Philippines; College of Medicine, University of the Philippines-Manila, PhilippinesDepartment of Surgery, University of the Philippines-Philippine General Hospital, Philippines; College of Medicine, University of the Philippines-Manila, PhilippinesForeign body ingestion is an infrequent cause of small bowel obstruction and, rarely, perforation. It is a common occurrence among pediatric patients, mentally impaired and the edentulous elderly population majority of which will pass through the gastrointestinal tract uneventfully. The likelihood of complications such as perforation, bleeding or fistula formation increases markedly particularly for sharp, stiff, and elongated objects (i.e. toothpicks, meat bones, pins, and razor blades). Diagnosis can be difficult as frequently patients are incognizant of the nature and time of ingestion. Imaging is commonly non-specific as well. We present an unusual case of a 65-year-old male who had an ileal perforation secondary to a coconut leaf midrib skewer initially presenting as small bowel obstruction. Intraoperatively, adhesions were seen in the ileum with note of the foreign body perforating two bowel loops that was not identified in preoperative imaging. This case highlights the importance of considering atypical causes of small bowel obstruction even in the background of previous surgery. Finally, early recognition, accurate diagnosis, and timely intervention are essential to improve patient outcomes and decrease mortality in such cases.http://www.sciencedirect.com/science/article/pii/S2352644024000566Foreign body ingestionSmall bowel obstructionSmall bowel perforationPostoperative adhesionsAcute surgical abdomen
spellingShingle Orlando O. Ocampo
Siegfredo R. Paloyo
Ferri P. David-Paloyo
Leonard Christopher T. Sena
Emmanuel T. Limpin
Eduardo C. Ayuste, Jr
Coconut leaf midrib skewer as a cause for small bowel obstruction and perforation: A case report
Trauma Case Reports
Foreign body ingestion
Small bowel obstruction
Small bowel perforation
Postoperative adhesions
Acute surgical abdomen
title Coconut leaf midrib skewer as a cause for small bowel obstruction and perforation: A case report
title_full Coconut leaf midrib skewer as a cause for small bowel obstruction and perforation: A case report
title_fullStr Coconut leaf midrib skewer as a cause for small bowel obstruction and perforation: A case report
title_full_unstemmed Coconut leaf midrib skewer as a cause for small bowel obstruction and perforation: A case report
title_short Coconut leaf midrib skewer as a cause for small bowel obstruction and perforation: A case report
title_sort coconut leaf midrib skewer as a cause for small bowel obstruction and perforation a case report
topic Foreign body ingestion
Small bowel obstruction
Small bowel perforation
Postoperative adhesions
Acute surgical abdomen
url http://www.sciencedirect.com/science/article/pii/S2352644024000566
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