title: Non-specific abdominal pain, an inconclusive CT scan and an unusual and puzzling finding at exploratory laparotomy.
abstract: A 71-year-old man presented to our hospital with generalised abdominal pain. Initial laboratory investigations were normal and an abdominal CT scan was inconclusive. The following day, persisting pain, generalised tenderness and haemodynamic instability prompted exploratory laparotomy. At laparotomy, two perforations of the proximal jejunum were identified caused by two 3 cm pieces of wood. The pieces of wood were retrieved and the perforations repaired primarily. The postoperative period was complicated by acute confusion but the patient went on to make a full recovery. On direct questioning, the patient was unable to explain the presence of wood within his gastrointestinal tract. One hypothesis was that he may have ingested this material during a period of acute confusion following an elective abdominal aortic aneurysm repair 8 years previously.
authors: Department of Surgery,  Gloucester Royal Hospital, Glocuester,  UK.
authors: Kapil
authors: K
authors: Sahnan
authors: David
authors: D
authors: McGowan
authors: Peter G
authors: PG
authors: Vaughan-Shaw
authors: Asmaa
authors: A
authors: Al-Allak
mesh_terms: D015746:Abdominal Pain / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D000368:Aged; D005547:Foreign Bodies / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D006801:Humans; D007416:Intestinal Perforation / Q000209:etiology / Q000601:surgery; D007583:Jejunum / Q000293:injuries / Q000601:surgery; D007813:Laparotomy; D008297:Male; D014057:Tomography, X-Ray Computed
references: World J Surg. 2006 Mar;30(3):372-7
references: 16479337
references: Am Fam Physician. 2005 Jul 15;72(2):287-91
references: 16050452
references: Mil Med. 1989 Jan;154(1):11-4
references: 2493598
references: Can J Surg. 1993 Dec;36(6):551-4
references: 8258137
references: Hepatogastroenterology. 2002 Jul-Aug;49(46):1017-22
references: 12143191