CASE REPORT: SMALL BOWEL PERFORATION WITH A FOREIGN BODY MIMICKING ACUTE PANCREATITIS

Abstract

TIn modern surgical practice, foreign bodies of the digestive tract are rare causes of an acute abdomen. If there is anamnestic evidence of foreign bodies entering the digestive tract, making the diagnosis is not a difficult task. However, in the case of an erased clinical picture or differential diagnosis with intercurrent disease, diagnosis and timely surgical treatment are a significant challenge. In this case, the entry into the lumen of the digestive tract of the for- eign body (bone) was unnoticed by the patient. The clinical picture and complaints presented to patients imitated the phenomena of acute pancreatitis: there was an alcohol load anamnestically at the prehospital stage; clinically there were shingles, vomiting that did not bring relief, palpation of the infiltrate in the epigastric region and elevated laboratory markers (blood amylase). In view of the absence of ultrasound and X-ray data for the presence of a pathological process for the verification of diagnosis, a computer tomography with the finding of the cause of abdominal pains was used - a foreign body (bone) in the lumen of the intestine. Laparoscopy removal of a foreign body and suturing the perforation of the intestinal wall was performed. The outcome is recovery, which proves the validity of the use of minimally invasive technologies in the treatment of such conditions.