Gastric Perforation After Incidental Ingestion Of Datun: Report Of An Unusual Case

2016-11-05T05-14-52Z
Source: The Southeast Asian Journal of Case Report and Review
Pal Naresh, Griwanmahavir S , Singhbikram J .
Gastric perforation is an extremely rare complication of foreign body ingestion, which usually presents with peritonitis. Ingestion of foreign bodies is a fairly common presentation and most of these cases can be managed conservatively. Larger foreign bodies however, can sometimes be difficult to manage. We present a peculiar case of gastric perforation following involuntary ingestion of a large foreign body i.e. Datun (It is a tree twig commonly used for cleaning teeth in rural India). A 57-year male presented to our accident and emergency department with complaints of pain in upper abdomen following involuntary ingestion of Datun while brushing his teeth 7-8 days back. During this period the patient was passing flatus and stools normally. He also had history of smoking and occasional consumption of alcohol. On examination of the abdomen the patient was found to have tenderness and guarding in upper abdomen. He was investigated further with a provisional diagnosis of perforation peritonitis. Free air under the diaphragm was evident on chest X ray. Upon exploratory laparotomy the patient was found to have a perforation in the body of the stomach with one half of the Datun protruding out of it. Primary closure of perforation was done after removal of the foreign body. Postoperative period was uneventful and the patient was discharged on the 5th post operative day. Symptomatic giant ingested FBscan be challenging to manage and may even require urgent surgical intervention if perforation is suspected. Although ingested foreign bodies are rarely symptomatic they should be considered in differential diagnosis of abdominal pain as well as possible cause of acute abdomen.


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