Jejunal perforation due to ingested buffalo bone mimicking acute appendicitis.

Area of Science:

• Gastroenterology
• Surgical Pathology

Background:

• Foreign body ingestion is common, but intestinal perforation is a rare complication.
• Ingested foreign bodies often present as acute abdomen, necessitating emergency surgery.
• Patients frequently do not recall ingesting sharp foreign objects.

Observation:

• A 55-year-old male presented with right iliac fossa pain, initially diagnosed as acute appendicitis.
• Intraoperative findings included purulent collection and inflamed bowel, raising suspicion for perforation.
• Two small jejunal perforations were discovered, with a sharp, bony object extracted.

Findings:

• The extracted object was identified as a 'buffalo bone' by the patient and caretaker.
• The buffalo bone perforated the jejunum, leading to localized peritonitis in the right iliac fossa.
• Post-operative recovery was uneventful after surgical closure of the perforations.

Implications:

• Intestinal perforation by foreign bodies should be considered in cases of acute abdomen.
• High clinical suspicion and awareness are crucial for diagnosing and managing such cases.
• Prompt surgical intervention is required for intestinal perforation due to foreign body ingestion.