Duodenal perforation in a child due to lollipop stick ingestion: A case report

Abstract

Background

Foreign body ingestion is common in children. While most ingested objects pass harmlessly through the gastrointestinal tract, some can cause severe complications like perforation, which may be life-threatening.

Case presentation

A 4-year-old boy who presented with a 24-h history of abdominal pain, fever, and vomiting. Physical examination revealed a distended and tender abdomen with signs of peritonitis. An abdominal radiograph showed free air under the diaphragm and gastric and intestinal distension. Abdominal ultrasonography confirmed intestinal dilation and the presence of free fluid. An emergency exploratory laparotomy was performed, revealing a punctiform perforation on the fourth portion of the duodenum caused by a lollipop stick protruding into the retroperitoneal space. The foreign body was removed, and a primary repair of the duodenal perforation was performed. A drain was placed near the repair site, and a nasogastric tube left in place for gastric decompression. The postoperative course was uneventful. The patient received intravenous antibiotics until the day of his discharge. He resumed oral diet on the third postoperative day. The drain was removed on the fifth postoperative day. He was discharged home on the seventh postoperative day.

Conclusion

Duodenal perforation due to foreign body ingestion is rare but should be included in the differential diagnosis of young children who present with peritonitis.