Bowel perforation caused by foreign body ingestion presenting as intestinal obstruction: a case report highlighting the importance of early diagnosis.

INTRODUCTION AND IMPORTANCE

Foreign body ingestion, particularly fish bones, is a well-known cause of gastrointestinal perforation. If not promptly diagnosed, it can lead to severe complications, including life-threatening situations. Timely recognition and intervention are crucial to prevent adverse outcomes.

CASE PRESENTATION

A 33-year-old male presented with abdominal pain, nausea, and cessation of gas and stool. Clinical evaluation and abdominal X-ray suggested intestinal obstruction, and the patient denied any history of foreign body ingestion. However, physical examination revealed significant peritoneal irritation. Abdominal computed tomography (CT) subsequently identified a retained foreign body at the terminal ileum, raising suspicion of intestinal perforation. Upon further inquiry, the patient recalled consuming fish with bones before symptom onset and participating in ball sports prior to the exacerbation of abdominal pain. Emergency laparoscopic surgery confirmed intestinal perforation caused by a fish bone. The bone was successfully removed, and the perforation was repaired. The patient had an uneventful recovery and was discharged on postoperative day 7.

CLINICAL DISCUSSION

Early diagnosis using CT imaging is essential in identifying bowel perforation caused by foreign bodies. In this case, the patient's history of recent fish consumption, along with clinical findings and imaging, guided the correct diagnosis and successful management.

CONCLUSION

This case highlights the importance of early diagnosis and CT imaging in detecting foreign body-induced bowel perforation. For patients presenting with intestinal obstruction but lacking typical signs such as free air, special attention should be given to thoroughly inquiring about the history of foreign body ingestion to avoid delayed diagnosis.