Korean J Gastroenterol.  2017 Nov;70(5):261-264. 10.4166/kjg.2017.70.5.261.

Small Bowel Perforation Caused by Press-through Package

• Kim JS
• Cha JM
• Kwak MS
• Yoon JY
• Jeon JW
• Shin HP
• Joo KR
• Lee JI
• Kim HY

• KMID: 2398873
• DOI: http://doi.org/10.4166/kjg.2017.70.5.261

Abstract

With an increased use of the press-through package (PTP) tablet, there has also been an increase in mis-swallowing cases, especially in elderly patients. We report a rare case of PTP-induced small bowel perforation and fistula formation with adjacent small bowel in a healthy elderly patient, who experienced persistent abdominal pain of unknown cause. A 62-year-old healthy man was admitted to our hospital with left abdominal pain that started one month ago. Neither abdominal tenderness nor rebound tenderness was present on physical examination. His vital signs and all other test results were within normal limits. However, a 2.5 cm curved radiopaque material within his thickened small intestine was incidentally detected on an abdominal computed tomography. He underwent laparoscopic small bowel resection, which revealed foreign body in the distal small intestine. Edema, perforation, and adhesions with the surrounding tissues were also noticed in the distal small intestine. Foreign body was turned out to be PTP, and this was considered to be responsible for the small bowel perforation and fistula formation. Precautions regarding PTP usage are necessary to prevent inadvertent PTP ingestion and its related complications, such as perforation, especially in the elderly population.

Keyword

Foreign body; Small intestine; Intestinal perforation; Fistula

MeSH Terms

Abdominal Pain
Aged
Eating
Edema
Fistula
Foreign Bodies
Humans
Intestinal Perforation
Intestine, Small
Middle Aged
Physical Examination
Vital Signs