Intestinal perforation by an ingested foreign body.
OBJECTIVE
To identify the computed tomography findings suggestive of intestinal perforation by an ingested foreign body.


METHODS
This was a retrospective study of four cases of surgically proven intestinal perforation by a foreign body, comparing the computed tomography findings with those described in the literature.


RESULTS
None of the patients reported having ingested a foreign body, all were over 60 years of age, three of the four patients used a dental prosthesis, and all of the foreign bodies were elongated and sharp. In all four patients, there were findings indicative of acute abdomen. None of the foreign bodies were identified on conventional X-rays. The computed tomography findings suggestive of perforation were thickening of the intestinal walls (in all four cases), increased density of mesenteric fat (in all four cases), identification of the foreign body passing through the intestinal wall (in three cases), and gas in the peritoneal cavity (in one case).


CONCLUSIONS
In cases of foreign body ingestion, intestinal perforation is more common when the foreign body is elongated and sharp. Although patients typically do not report having ingested such foreign bodies, the scenario should be suspected in elderly individuals who use dental prostheses. A computed tomography scan can detect foreign bodies, locate perforations, and guide treatment. The findings that suggest perforation are thickening of the intestinal walls, increased mesenteric fat density, and, less frequently, gas in the peritoneal cavity, often restricted to the point of perforation.
MD, Radiology Resident at Hospital São Vicente - Funef, Curitiba, PR, Brazil.
Gabriel Cleve
GC
Nicolodi
MD, Radiologist and Preceptor at Hospital São Vicente - Funef, Curitiba, PR, Brazil.
Cesar Rodrigo
CR
Trippia
MD, Radiologist and Preceptor at Hospital São Vicente - Funef, Curitiba, PR, Brazil.
Maria Fernanda F S
MF
Caboclo
MD, Radiology Resident at Hospital São Vicente - Funef, Curitiba, PR, Brazil.
Francisco Gomes
FG
de Castro
MD, Radiology Resident at Hospital São Vicente - Funef, Curitiba, PR, Brazil.
Wagner Peitl
WP
Miller
MD, Radiology Resident at Hospital São Vicente - Funef, Curitiba, PR, Brazil.
Raphael Rodrigues
RR
de Lima
MD, Radiology Resident at Hospital São Vicente - Funef, Curitiba, PR, Brazil.
Leandro
L
Tazima
MD, Radiology Resident at Hospital São Vicente - Funef, Curitiba, PR, Brazil.
Jamylle
J
Geraldo
Abdomen, acute; Foreign bodies; Intestinal perforation; Intestine, small; Tomography, X-ray computed