Case report
Duodenal perforation because of swallowed ballpoint pen and its laparoscopic management: report of a case

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Abstract

Accidental ingestion of foreign objects by teenagers or young adults without mental impairment is a rare event. We present a case of a patient who unintentionally swallowed a ballpoint pen several days before seeking medical attention. She concealed the event until abdominal radiographs revealed the foreign object. Because swallowed foreign objects can be potentially harmful, they should be removed endoscopically as soon as possible to prevent development of complications. At times, they need to be removed operatively. This report describes the laparoscopic removal of a ballpoint pen that perforated the duodenum.

Section snippets

Case report

A 15-year-old female patient was brought to the emergency unit by her mother because of epigastric discomfort associated with nausea and blood-streaked vomitus. Routine laboratory tests revealed leukocytosis, but all other variables were within normal range. At that time, she was diagnosed with peptic ulcer and treated accordingly; thus, no further tests were obtained and she was sent home. During the next 4 days, she continued to feel sick and febrile but no further vomiting occurred. She

Discussion

Duodenal perforation because of ingested foreign objects is uncommon [2]. When a potentially harmful foreign body (sharp objects, button batteries, or toxic objects) is observed in the duodenum, it should be removed endoscopically as soon as possible to prevent development of complications [3]. There have been some reports concerning migration of metallic sharp objects to adjacent organs such as the liver, resulting in fever of unknown origin or a liver abscess [4].

Most perforations produced by

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