title: Small intestine perforation due to accidental press-through package ingestion in an elderly patient with Lewy body dementia and recurrent cardiopulmonary arrest.
abstract: An octogenarian with Lewy body dementia presented to our hospital in cardiac arrest and was successfully resuscitated. Although he had abdominal pain the previous day, small bowel wall oedema and ascites were the only abnormalities noted on abdominal CT. Despite treatment with catecholamines and antimicrobials, he died of recurrent cardiopulmonary arrest later the same day. An autopsy showed that the patient's death was the result of a small bowel perforation caused by accidental ingestion of a press-through package (PTP). Precautions regarding PTP use and improved packaging design are necessary to prevent PTP ingestion, especially in elderly patients with dementia.
authors.affiliation: Department of Cardiology, Tokyo Metropolitan Geriatric Hospital, Tokyo, Japan Department of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Hashizume
authors.affiliation: Department of Radiology, Tokyo Metropolitan Geriatric Hospital, Tokyo, Japan.
authors.forename: Aya M
authors.initials: AM
authors.lastname: Tokumaru
authors.affiliation: Department of Cardiology, Tokyo Metropolitan Geriatric Hospital, Tokyo, Japan.
authors.forename: Kazumasa
authors.initials: K
authors.lastname: Harada
mesh_terms: D000369:Aged, 80 and over; D004349:Drug Packaging; D017809:Fatal Outcome; D005547:Foreign Bodies / Q000150:complications*; D006323:Heart Arrest / Q000150:complications*; D006801:Humans; D007416:Intestinal Perforation / Q000209:etiology*; D007421:Intestine, Small / Q000293:injuries*; D020961:Lewy Body Disease / Q000150:complications*; D012008:Recurrence