title: A comparative study of small intestinal perforation secondary to foreign body and other non-traumatic causes.
abstract: BACKGROUND
  Little was known about gastrointestinal perforation secondary to foreign body in adults, which was only documented by several case series reports. The aim of this study was to characterize it with comparative methods.
  
  
  METHODS
  A retrospective study was conducted on twenty patients with the diagnosis of gastrointestinal perforation secondary to foreign body between January 2003 and October 2013. The perforations were all located in the small intestine and compared to eighty-seven patients with non-traumatic small intestinal perforation.
  
  
  RESULTS
  35% of the patients in the foreign body group were over 65 years of age, which is much higher than the local elderly population ratio (p=0.002). In the foreign body group, more patients presented without diffuse abdominal physical signs (p=0.008) and preoperational CT scans had higher accuracy (p=0.027). Perforation repair was performed more often (p=0.024). Mean MPI was 19.9 and the morbidity rate was 35%, significantly lower than in the cases of other causes (p=0.001, 0.041). Mean duration of hospitalization was 11.5 days and was shorter compared to other causes (p=0.038).
  
  
  CONCLUSIONS
  Clinical performance of small intestinal perforation secondary to foreign body is atypical, and preoperative diagnosis relies on CT scans. Primary perforation closure is safe and effective, and relatively better outcomes can be achieved.
authors.affiliation: Department of General Surgery, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Chen
authors.affiliation: Department of Interventional Radiology, The First People's Hospital of Changzhou, Affiliated Third Hospital of Soochow University, Changzhou, Jiangsu, China.
authors.forename: Yuanquan
authors.initials: Y
authors.lastname: Huang
authors.affiliation: Department of General Surgery, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.
authors.forename: Yongyou
authors.initials: Y
authors.lastname: Wu
authors.affiliation: Department of General Surgery, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.
authors.forename: Kui
authors.initials: K
authors.lastname: Zhao
authors.affiliation: Department of General Surgery, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.
authors.forename: Baosong
authors.initials: B
authors.lastname: Zhu
authors.affiliation: Department of General Surgery, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.
authors.forename: Tengfei
authors.initials: T
authors.lastname: He
authors.affiliation: Department of General Surgery, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.
authors.forename: Chungen
authors.initials: C
authors.lastname: Xing
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005547:Foreign Bodies / Q000000981:diagnostic imaging / Q000401:mortality* / Q000601:surgery; D006801:Humans; D007416:Intestinal Perforation / Q000000981:diagnostic imaging / Q000401:mortality* / Q000601:surgery; D007421:Intestine, Small / Q000000981:diagnostic imaging / Q000601:surgery*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods; D014421:Turkey / Q000453:epidemiology