Small bowel perforation secondary to foreign body ingestion mimicking acute appendicitis: Case report

RATIONALE: Foreign body ingestion is often encountered in clinical practice; however, intestinal perforation owing to foreign body ingestion is rare. PATIENT CONCERNS: Here, we present the cases of 2 patients who accidentally swallowed foreign bodies and later presented with pain in the right lower abdominal quadrant. DIAGNOSES: Both patients were initially diagnosed with acute appendicitis and underwent immediate emergency laparotomy. INTERVENTIONS: During the operation, the appendix was found to be only mildly inflamed. On transection of the appendix, the mucosa was found to be inflamed, and yellow-white exudate was noted. We, therefore, decided to explore the entire bowel. The bowel examination revealed small bowel perforations, and palpation of the adjacent bowel revealed a hard, sharp object. The object was removed through the perforation site, the perforation was repaired, and the abdomen was closed in layers. OUTCOME: The postoperative recovery, in both cases, was uneventful. LESSONS: Patients who swallow sharp or large foreign bodies should undergo endoscopy as soon as possible to avoid intestinal perforation. Clinicians should inquire about a history of foreign body ingestion. The preoperative diagnosis of intestinal perforation secondary to foreign body ingestion requires a high degree of clinical suspicion and awareness.