We present the case of a 91-year-old woman with mild cognitive impairment, admitted for a respiratory infection and diarrhoea of several weeks’ evolution. The physical examination found fever of 37.9 °C and diffuse abdominal pain without signs of peritoneal irritation. Noteworthy test results included a C-reactive protein value of 99 mg/dl.
Abdominal computed tomography was performed, finding two bony foreign bodies in the sigmoid colon (Fig. 1), without associated complications.
In view of the imaging findings, an emergency colonoscopy was performed without sedation, during which the more distal bone was able to be extracted using foreign body forceps (Fig. 2). At 24 h, the proximal one was removed under deep sedation using a polypectomy snare. Evolution was favourable with antibiotic treatment and discharge 10 days later.
Discussion
Accidental ingestion of chicken bones is rare, but is more common in elderly patients and those with cognitive impairment.1
Diverticular disease constitutes a predisposing factor for retention of swallowed foreign bodies.2 As well as diverticulitis,3 perforation,4,5 abscesses and fistulas1 can occur. In our case, after using computed tomography to rule out complications, surgery was avoided thanks to successful endoscopic treatment. Of note is the significant length of the bones and their extraction whole (Fig. 3). We do not know how long they had been in situ before symptoms arose.
Please cite this article as: Castillo-López G, Rodríguez-Alcalde D, Martínez Caballero C, Martinelli G. Huesos de pollo impactados entre divertículos de sigma. Gastroenterol Hepatol. 2021;44:570–571.
