A Case in Which Intraoperative Ultrasonography Was Useful in Identifying a Gastrointestinal Foreign Body That Had Caused Small Bowel Perforation

Abstract

The patient, a 79-year-old woman, presented to our hospital with a two-week history of persistent abdominal pain. An abdominal CT scan revealed a linear hyperabsorptive zone in the small intestine in the right lower abdomen and free gas in the abdominal cavity. We diagnosed the patient as having gastrointestinal perforation caused by a fishbone, and prepared for emergency surgery. Intraoperative exploration revealed strong adhesions between segments of the intestine due to peritoneal dialysis, making it difficult to identify the foreign body and perforation site. Therefore, we utilized intraoperative ultrasonography to confirm the presence of the foreign body in the intestinal tract. The adhesions of the intestinal tract where the foreign body was present were carefully dissected. The foreign body was then extracted by perforating the intestinal tract in a manner that allowed the foreign body to be pushed out of the lumen. The perforation was closed with an absorbable suture and the operation was completed. The patient had a satisfactory postoperative course and was discharged from the hospital on the 15th postoperative day. Intraoperative ultrasonography holds promise for actively identifying foreign bodies in the gastrointestinal tract while reducing the operating time and improving surgical outcomes.