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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Elsevier
2024-06-01
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| 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. |
| format | Article |
| id | doaj-art-7dfd2b0002b94b6fb518be92188a428d |
| institution | OA Journals |
| issn | 2352-6440 |
| language | English |
| publishDate | 2024-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Trauma Case Reports |
| 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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