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Double duodenal perforation following foreign body ingestion
  1. Andrew W Gardner,
  2. Rami W Radwan,
  3. Miles C Allison,
  4. Rhodri J Codd
  1. Department of General Surgery, Aneurin Bevan University Health Board, Newport, UK
  1. Correspondence to Rami W Radwan, radwanr{at}


Intentional ingestion of a foreign body in adults is a rare clinical presentation. This case is one of a 27-year-old Sudanese man who presented having swallowed a ballpoint pen intentionally. Clinical examination and plain chest radiograph exhibited no signs indicative of perforation with only a raised C reactive protein identified on blood tests. Subsequent gastroscopy revealed that the pen had simultaneously perforated the duodenum at both D1 and D3 requiring removal via a laparotomy. The patient fully recovered and was discharged 2 weeks postoperatively following psychiatric input.

  • general surgery
  • gastrointestinal surgery

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  • Contributors AWG: literature search and writing report. RWR: literature search and editing. RJC: consultant involved in patient care. MCA: consultant involved in patient care.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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