Abdominal pain and hematuria: duodenal perforation from ingested foreign body causing ureteral obstruction and hydronephrosis

Journal of Surgical Case Reports
Nina KolbeRenato Albaran

Abstract

Foreign body (FB) ingestion is a relatively common reason for visits to the emergency room. If the FB is symptomatic or damaging to the patient, either endoscopic or surgical intervention should ensue. We present a case of abdominal pain and hematuria beginning ∼24 h after an incidental FB ingestion. Initial CT imaging defined a linear opacity perforating through the posterior duodenal wall abutting the ureter causing inflammation and hydronephrosis. After two unsuccessful endoscopic attempts at retrieval, we were able to identify the object with the aid of intraoperative fluoroscopy and surgically remove the FB. The patient recovered uneventfully and was discharged home. Posterior duodenal perforation by an FB may not manifest with obvious localized or systemic symptoms unless the perforation involves surrounding structures such as the aorta, vena cava or ureter. In such cases, surgical intervention is required for FB removal.

References

Feb 16, 2006·World Journal of Surgery·Brian K P GohWai-Keong Wong
Nov 3, 2007·The Journal of Emergency Medicine·Giuseppe R NigriGiovanni Ramacciato
Dec 17, 2010·World Journal of Gastrointestinal Endoscopy·Sameer R IslamSreeram Parupudi
Oct 24, 2013·World Journal of Gastroenterology : WJG·Bülent ErbilMehmet Mahir Özmen
Jul 18, 2015·World Journal of Gastroenterology : WJG·Kyong Hee HongJae Hee Cho

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Citations

Oct 9, 2016·Abdominal Radiology·Tassia Soraya Araujo PaixãoGiovanni Guido Cerri
Aug 12, 2021·Acta Radiologica Open·Devendra KumarDavid Blair Macdonald
Dec 1, 2021·Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery·Nathaniel MillerSteven Hong

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