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Summary
This study reports six cases of small intestine perforation, exploring potential causes like vascular issues and foreign body reactions from ingested vegetal residues. Treatment involved intestinal resection and anastomosis.
Area of Science:
- Gastroenterology
- Pathology
Background:
- Small intestine perforation is a serious condition requiring prompt diagnosis and surgical intervention.
- Etiologies for small intestine perforation are diverse, including spontaneous, secondary to purpura, and foreign body reactions.
Observation:
- Six cases of small intestine perforation were analyzed, with one secondary to anaphylactoid purpura and five spontaneous.
- Ingestion of an iced drink precipitated perforation in two cases.
- Vascular genesis was proposed for two cases, with perforations located in the final ileal ansa at the mesenteric margin.
Findings:
- Histology in three cases revealed double refraction crystals from vegetal residues, suggesting a foreign body reaction leading to abscess and perforation.
- These foreign body-induced perforations occurred in an ileal ansa approximately 3 meters from the terminal ileum, also at the mesenteric margin.
- All patients underwent intestinal resection and end-to-end, single-layer anastomosis.
Implications:
- Understanding the diverse etiopathogenesis of small intestine perforation, including vascular and foreign body mechanisms, is crucial for accurate diagnosis.
- The role of ingested vegetal residues as a foreign body causing intestinal perforation warrants further investigation.
- Surgical management via intestinal resection and anastomosis remains the standard treatment for such perforations.