Gradual colonic impaction of a chicken bone associated with inflammatory pseudotumor formation and nonocclusive colon ischemia.
Foreign body (FB) ingestion is a common clinical problem and most FBs pass through the gastrointestinal tract without the need for intervention. A wide spectrum of clinical presentations may be possible and these can be either acute or chronic. We present a case of an 83-year-old woman featuring insidious abdominal discomfort who was hospitalized in our institution due to worsening symptoms. She underwent contrast-enhanced computed tomography (CT) evaluation which showed the presence of a significant parietal thickening of the transverse and descending colon, a mesenteric loose tissue imbibition, venous engorgement, and no filling defect of visceral arteries, suggesting a condition of nonocclusive colon ischemia. A hyperdense FB was identified in the sigma and was associated with a small pseudotumoral mass. The patient underwent surgical exploration which confirmed the hypoperfusional state of the colon, showing the presence of a chicken bone perforating the sigma and lying in the context of a pseudotumoral mass. Our experience shows how contrast-enhanced CT is feasible and can be strongly recommended as a first-line imaging tool on suspicion of colon ischemia and also how it can easily identify the underlying cause, in our case a FB sealed perforation of the sigma with pseudotumoral mass formation.
Department of Diagnostic Imaging, Molecular Imaging, Interventional Radiology and Radiotherapy, Policlinico Tor Vergata (PTV), Viale Oxford 81, 00133 Rome, Italy.
Stefania
S
Fosi
Department of Diagnostic Imaging, Molecular Imaging, Interventional Radiology and Radiotherapy, Policlinico Tor Vergata (PTV), Viale Oxford 81, 00133 Rome, Italy.
Simone
0000-0002-0363-3140
S
Altobelli
Department of Diagnostic Imaging, Molecular Imaging, Interventional Radiology and Radiotherapy, Policlinico Tor Vergata (PTV), Viale Oxford 81, 00133 Rome, Italy.
Alessio
A
Bindi
Department of Experimental Science and Surgery, Policlinico Tor Vergata (PTV), Viale Oxford 81, 00133 Rome, Italy.
Massimo
0000-0001-9012-7328
M
Villa
Department of Experimental Science and Surgery, Policlinico Tor Vergata (PTV), Viale Oxford 81, 00133 Rome, Italy.
Flavio
F
De Sanctis
Department of Experimental Science and Surgery, Policlinico Tor Vergata (PTV), Viale Oxford 81, 00133 Rome, Italy.
Mauro
0000-0002-7968-2109
M
Montuori
Department of Experimental Science and Surgery, Policlinico Tor Vergata (PTV), Viale Oxford 81, 00133 Rome, Italy.
Edoardo
E
Ricciardi
Department of Experimental Science and Surgery, Policlinico Tor Vergata (PTV), Viale Oxford 81, 00133 Rome, Italy.
Piero
P
Rossi
Department of Experimental Science and Surgery, Policlinico Tor Vergata (PTV), Viale Oxford 81, 00133 Rome, Italy.
Giuseppe
G
Petrella
Department of Diagnostic Imaging, Molecular Imaging, Interventional Radiology and Radiotherapy, Policlinico Tor Vergata (PTV), Viale Oxford 81, 00133 Rome, Italy.
Giovanni
G
Simonetti