Ileal perforation by a solidified root pulp - Minimally invasive surgery management

Area of Science:

• Gastroenterology
• Surgical Pathology
• Medical Case Reports

Background:

• Foreign body (FB) ingestion is uncommon but can lead to serious complications such as intestinal perforation.
• Delayed diagnosis of FB ingestion can result in significant morbidity and mortality.
• The increasing prevalence of dental procedures raises concerns about iatrogenic FB ingestion.

Purpose of the Study:

• To report a case of delayed distal ileal perforation secondary to accidental foreign body ingestion.
• To highlight the diagnostic challenges associated with foreign body perforation.
• To emphasize the importance of considering foreign body ingestion in patients with unexplained abdominal pain.

Main Methods:

• A case report of a 46-year-old male with delayed presentation of right iliac fossa pain.
• Diagnostic workup included computed tomography (CT) scan of the abdomen.
• Surgical management involved diagnostic laparoscopy, foreign body removal, and primary perforation repair.

Main Results:

• CT revealed a foreign body in the distal ileum with contained perforation.
• The foreign body was identified as solidified root pulp.
• The patient underwent successful surgical removal and primary closure of the perforation.

Conclusions:

• Delayed diagnosis of foreign body ingestion can lead to significant morbidity.
• Solidified root pulp is a rare but possible foreign body leading to intestinal perforation.
• Clinicians must maintain a high index of suspicion for foreign body ingestion, especially in patients with a history suggestive of dental procedures.