PERFORATION OF THE SMALL INTESTINE BY SWALLOWED FOREIGN BODIES2

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Abstract
Summary: Five cases of perforation of the ileum and one case of perforation of a Meckel's diverticulum by an ingested foreign body have been reported. In addition, nine cases from the literature have been reviewed. The condition is not common, and apparently has never been diagnosed before operation or autopsy. This is because of a close similarity to acute appendicitis in some cases; in others, the clinical features have been too confusing to suggest an origin for the peritonitis. This latter group may be confusing because of the rarity of similar cases in any one surgeon's experience. To aid in the diagnosis of the condition a theoretical postulate, consisting of (a) colic, (b) peritonitis, and (c) lower abdominal locus, has been advanced. When analysed, many of the acute cases actually do approximate to this theoretical concept. The influence of the omentum and of the effective size of the perforation lias been stressed as modifying the above features of a typical case. Although uncommon, a perforation of the small gut by a foreign body should be kept in mind as a possible cause of an obscure peritonitis.

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