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BMJ Case Reports 2013; doi:10.1136/bcr-2013-008635
  • CASE REPORT

Duodenal perforation caused by a bird feather

  1. Anil Kumar2
  1. 1Department of General Surgery, S.C.B Medical College, Cuttack, Odisha, India
  2. 2Department of Surgery, S.C.B Medical College, Cuttack, Odisha, India
  1. Correspondence to Dr Manash Ranjan Sahoo, manash67{at}gmail.com

Summary

Ingestion of gastrointestinal (GI) foreign bodies represents a challenging clinical scenario. The greater risk is at extremes of age, in those wearing dentures, alcoholics and mentally handicapped. We present a case of duodenal perforation caused by a bird feather. A 64-year-old man was presented with abdominal pain for 4 days. Abdominal examination showed signs of peritonitis. The erect abdominal x-ray showed free gas under diaphragm. Exploratory laparotomy showed purulent fluid, but no definite site of perforation could be found. So the abdomen was closed with a drain in Morison's pouch. The postoperative recovery was uneventful. He came for a repeat check-up at 4 weeks with dull aching pain in the upper abdomen and was advised for a routine upper GI endoscopy which revealed a feather penetrating the first part of the duodenum, which was removed with a foreign body removing forceps. GI foreign bodies represent a significant problem and an increased level of suspicion is important for timely diagnosis and treatment.

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