Chicken bone fragment traveled for a month in baby girl's intestine

HT• June 30, 2019 16:17

A 12-year-old girl in Hanoi had a stomachache and high fever due to a piece of chicken bone she swallowed a month earlier that punctured her intestines.

The child was brought to the Emergency Department of Xanh Pon Hospital on the afternoon of June 25, with a dull abdominal pain in the lower abdomen that gradually increased, and the disease had been progressing for two weeks before being admitted to the hospital. Three days ago, the child had a stomachache with a high fever of 38-39 degrees Celsius, fatigue, and poor appetite. The family took the child to the hospital many times and was diagnosed with digestive disorders and given a prescription to take at home.

Dr. Nguyen Thi Hong Van, Department of Pediatric Surgery, said that initially, doctors suspected that the patient had an infection in the abdominal cavity. However, the abdominal ultrasound only showed thickening of some small intestinal loops, and the lower abdominal X-ray did not detect any abnormalities. A CT scan of the abdomen discovered a foreign object about 3 cm long that had punctured the intestinal wall and caused localized peritonitis in the abdomen. The patient underwent laparoscopic surgery immediately afterwards.

Mảnh xương gà đâm thủng đại tràng bệnh nhi. Ảnh: Bệnh viện cung cấp.

A piece of chicken bone punctured the child's colon. Photo: Provided by the hospital.

Dr. Tran Van Quyet, Deputy Head of the Department of Pediatric Surgery, who directly performed the surgery, said that the perforated intestine was the sigmoid colon (the last part of the colon), only about 20 cm from the edge of the anus. The bone fragment had been stuck there for a long time, causing the intestine to become inflamed and thick, and the bone tip punctured the intestinal wall. The perforation was covered by small intestine loops, isolating the inflammation from the abdominal cavity, so the patient's symptoms were very faint and progressed slowly.

In this case, usually if the hole is not closed by the small intestine loop, feces will spill into the abdominal cavity, causing infection, severe poisoning, and even death.

The patient was operated on by a laparoscopic surgical team to remove the foreign object, suture the perforated sigmoid colon, clean the abdominal cavity, place an abdominal drain for monitoring, and remove the small intestine loop to drain the ileum.

"Within the next 2 months, the patient will need another surgery to close the ileostomy," said Dr. Quyet.

After waking up from surgery, the patient said he may have swallowed a piece of chicken bone during a class party a month earlier. The patient is now fever-free, alert, and no longer has a stomachache. With his health improving, he is expected to be discharged in the next few days.