Mechanical small bowel obstruction caused by a foreign body (vitamin supplements)
Presentation
Acute abdominal pain and discomfort, progressive in nature. Apyrexial.
Patient Data
Features of small bowel obstruction with an intraluminal, mixed density, rectangular foreign body within the ileum. There is no free intraperitoneal air. There is intraluminal gas distal to the identified foreign body.
Age-appropriate thoraco-lumbar and pelvic degenerative changes.
Features of mechanical small bowel obstruction secondary to an impacted foreign body within the terminal ileum. The foreign body is of an unusual disfigured dual rectangular shape, with linear internal defects and air. There are small bowel feces proximal to the site of obstruction and impacted foreign body.
There is left hypochondrial mesenteric inflammation adjacent to a small bowel loop, however no free intraperitoneal air regionally.
Age-appropriate coronary vascular and ventricular outflow tract calcified plaque, thoracic and abdominal aortic calcified plaque, thoraco-lumbar and pelvic degenerative changes. There is a known history of previous trauma and healed right hip and pelvic fractures.
Case Discussion
On questioning the patient and investigating a potential source of the foreign bodies, it was concluded that the foreign body likely represented 2 large vitamin supplement tablets that failed to dissolve and coalesced. The undissolved dual tablets passed through the stomach and small bowel and impacted within the terminal ileum to cause mechanical small bowel obstruction.
While awaiting surgical intervention, the patient spontaneously passed the tablets and the symptoms resolved completely.
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