Abstract
An 88-year-old woman was admitted to our hospital with the chief complaint of right lower abdominal pain and fever of 38°C. Detailed evaluation using multi-detector computed tomography (MDCT) with volume rendering (VR) and multiplanar reconstruction (MPR) images showed a foreign body corresponding to a press-through package (PTP) in the ileum with wall thickening and air bubble near the PTP. We diagnosed peritonitis due to perforation or penetration. Urgent laparotomy under general anesthesia found the PTP, which had penetrated the mesenterium 40 cm proximal from the end of the ileum. We resected the clustered ileum for a length of 30 cm, and constructed ileo-ileostomy. The treatment strategy for mis-swallowed PTP differs with the location. It is important to identify the location of PTP exactly using VR and MPR images obtained by MDCT, and it is necessary to perform urgent laparotomy in patients suspected of perforation or penetration in the gastrointestinal tract. Abdominal MDCT examination is useful to decide the treatment method for a foreign body in the gastrointestinal tract.
