Abstract
•We discuss a case of gastric perforation caused by a sharp chicken bone ingestion.•Early diagnosis lead to successful minimally invasive management using an endoscopic approach.•High degree of suspicion is important in diagnosing foreign body related gastrointestinal complications as the clinical presentation can be elusive.•Early diagnosis can allow the utilization of less invasive therapeutic interventions, subsequently leading to faster recovery.•In the right context, therapeutic endoscopy can help to avoid more aggressive surgical interventions.
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.
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.
This case illustrates the importance of early diagnosis of foreign body related gastrointestinal perforations and emphasizes the role of therapeutic endoscopy.