Articles T67 Số CDD10 - HN Bệnh viện Nhi Đồng 2 - HN Trường Đại học Nguyễn Tất Thành

JEJUNAL PERFORATION CAUSED BY MULTIPLE SHARP CHICKEN-BONE FOREIGN BODIES IN A 13-YEAR-OLD GIRL: A CASE REPORT AND LITERATURE REVIEW

Pham Ngoc Thach1,2, Nguyen Hien1,2, Truong Hoai Lam3,4
1 Children's Hospital 2
2 Bệnh viện Nhi Đồng 2
3 Ho Chi Minh City University of Medicine and Pharmacy
4 Đại Học y Dược TP.HCM
DOI: 10.52163/yhc.v67icd10.5870
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Keywords
foreign body ingestion; sharp foreign body; jejunal perforation; adolescent; eating behavior.
Abstract

Background: Sharp gastrointestinal foreign bodies may cause small-bowel perforation and peritonitis; ingestion of multiple sharp objects is rare in adolescents.

Case presentation: A 13-year-old girl presented with right iliac fossa pain and bilious vomiting. Examination suggested localized peritonitis. Abdominal CT demonstrated multiple linear hyperdense foreign bodies in the small bowel. She had undergone surgery one year earlier for ileal perforation caused by a wooden toothpick and reported rapid, distracted eating. Exploratory laparotomy identified a jejunal perforation 20 cm distal to the duodenojejunal flexure caused by a sharp chicken bone; a total of seven sharp bone fragments were removed and the perforation was primarily repaired. Recovery was uneventful; oral intake resumed on postoperative day 3 and she was discharged on day 6, with no complications at 1-month follow-up and behavioral counseling provided.

Conclusion: Small-bowel perforation from sharp foreign bodies in older children is uncommon but potentially life-threatening. Early CT-based diagnosis, timely surgery with thorough bowel inspection, and behavioral counseling are essential to prevent missed foreign bodies and recurrence.

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