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Small intestine perforation due to accidental press-through package ingestion in an elderly patient with Lewy body dementia and recurrent cardiopulmonary arrest
  1. Tsuyoshi Hashizume1,2,
  2. Aya M Tokumaru3,
  3. Kazumasa Harada1
  1. 1Department of Cardiology, Tokyo Metropolitan Geriatric Hospital, Tokyo, Japan
  2. 2Department of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
  3. 3Department of Radiology, Tokyo Metropolitan Geriatric Hospital, Tokyo, Japan
  1. Correspondence to Dr Tsuyoshi Hashizume, thashizume-tky{at}


An octogenarian with Lewy body dementia presented to our hospital in cardiac arrest and was successfully resuscitated. Although he had abdominal pain the previous day, small bowel wall oedema and ascites were the only abnormalities noted on abdominal CT. Despite treatment with catecholamines and antimicrobials, he died of recurrent cardiopulmonary arrest later the same day. An autopsy showed that the patient's death was the result of a small bowel perforation caused by accidental ingestion of a press-through package (PTP). Precautions regarding PTP use and improved packaging design are necessary to prevent PTP ingestion, especially in elderly patients with dementia.

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