%0 Journal Article
%T Gradual Colonic Impaction of a Chicken Bone Associated with Inflammatory Pseudotumor Formation and Nonocclusive Colon Ischemia
%A Stefania Fosi
%A Simone Altobelli
%A Alessio Bindi
%A Massimo Villa
%A Flavio De Sanctis
%A Mauro Montuori
%A Edoardo Ricciardi
%A Piero Rossi
%A Giuseppe Petrella
%A Giovanni Simonetti
%J Case Reports in Radiology
%D 2014
%I Hindawi Publishing Corporation
%R 10.1155/2014/215465
%X Foreign body (FB) ingestion is a common clinical problem and most FBs pass through the gastrointestinal tract without the need for intervention. A wide spectrum of clinical presentations may be possible and these can be either acute or chronic. We present a case of an 83-year-old woman featuring insidious abdominal discomfort who was hospitalized in our institution due to worsening symptoms. She underwent contrast-enhanced computed tomography (CT) evaluation which showed the presence of a significant parietal thickening of the transverse and descending colon, a mesenteric loose tissue imbibition, venous engorgement, and no filling defect of visceral arteries, suggesting a condition of nonocclusive colon ischemia. A hyperdense FB was identified in the sigma and was associated with a small pseudotumoral mass. The patient underwent surgical exploration which confirmed the hypoperfusional state of the colon, showing the presence of a chicken bone perforating the sigma and lying in the context of a pseudotumoral mass. Our experience shows how contrast-enhanced CT is feasible and can be strongly recommended as a first-line imaging tool on suspicion of colon ischemia and also how it can easily identify the underlying cause, in our case a FB sealed perforation of the sigma with pseudotumoral mass formation. 1. Introduction Foreign body ingestion and food bolus impaction commonly occur, and while more than 80% of foreign objects pass through the gastrointestinal (GI) tract without the need for intervention, 20% and 1% of them will, respectively, need endoscopic or surgical procedures. The most frequently ingested foreign bodies in adults are fish bones (9¨C45%), bones (8¨C40%), and dentures (4¨C18%). Ingested foreign bodies mostly cause nonspecific symptoms; however, when accompanied by GI perforation, patients may complain of abdominal pain (95%), fever (81%), or localized peritonitis (39%). Imaging plays an important role in the diagnostic process of both FBs localization and identification of related complication such as perforation and bowel ischemia. While other imaging techniques lack sensitivity and specificity, contrast-enhanced CT with postprocessing reconstructions is of choice permitting achieving a good grade of accuracy. 2. Case Presentation An 83-year-old woman was admitted to the emergency department of our hospital on May 5 with a clinical history of abdominal pain, nausea, vomiting, and diarrhea which started three days previously. Her past medical history was characterized by chronic atrial fibrillation, cardiomegaly, and a not-further-specified
%U http://www.hindawi.com/journals/crira/2014/215465/