title: Successful endoscopic management of gastric perforation caused by ingesting a sharp chicken bone.
abstract: BACKGROUND
  Gastrointestinal perforation related to foreign body ingestion is uncommon. Surgical interventions aiming at removal of the offending agent and restoration of bowel continuity are sought when perforations occur. Presentation of case A 68 year old male presented with epigastric abdominal pain and anorexia for 2 days. On examination, he was febrile and had localized epigastric tenderness. Laboratory investigations revealed marked leucocytosis with no other abnormalities. Computed tomography revealed the presence of a foreign body penetrating through the full thickness of the gastric wall with its tip lying adjacent to the pancreatic head. Endoscopic trial to extract the foreign body was successfully carried out. The gastric defect was sealed by applying an endoscopic metallic clip.
  
  
  CONCLUSIONS
  Gastric perforations secondary to foreign body ingestion usually follow an elusive clinical course and are rarely diagnosed early in its course. Early diagnosis allows for the utilization of minimally invasive management. Unfortunately, Most reported cases were diagnosed after intra-abdominal processes, such as abscesses, have ensued.
  
  
  CONCLUSIONS
  This case illustrates the importance of early diagnosis of foreign body related gastrointestinal perforations and emphasizes the role of therapeutic endoscopy.
authors.affiliation: Department of General Surgery, McGill University Health Centre, Montreal, Canada. Electronic address: mohammedfsh@yahoo.com.
authors.forename: Mohammed F
authors.initials: MF
authors.lastname: Shaheen
authors.affiliation: Department of General Surgery, Hôpital du Suroîtl, Salaberry-de-Valleyfield, Canada; Department of General Surgery, Barrie Memorial Hospital, Ormstown, Canada.
authors.forename: Pierre
authors.initials: P
authors.lastname: Barrette
keywords: Endoscopy; Foreign body; Gastric perforation; Minimally invasive