A Case of Duodenal Perforation due to Ingested Neem Twigs Mimicking Acalculous Cholecystitis
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Date
2019-05
Journal Title
Journal ISSN
Volume Title
Publisher
International Society for Contemporary Medical Research
Abstract
Introduction: Most foreign bodies in the G.I tract areasymptomatic and probably pass spontaneously in stool. Fewmay cause complications and require interventions. Diagnosiscan be a challenge in certain cases. We present a case in whichthe ingestion of a Neem Twig caused duodenal perforationmimicking Acalculous Cholecystitis.Case report: A 63-year-old lady visited emergency withacute abdominal pain of 2 day history. Computed tomography(CT) showed mildly thickened Gall bladder with loculatedpericholecystic fluid collection which is extending intosubcapsular region of segment III of liver. A LaparoscopicCholecystectomy was planned in view of Acalculouscholecystitis. Intraoperative, an Omental phlegmon guardinga Neem (Azadirachta indica) twig which perforated out ofduodenum was found. Laparoscopy was converted to an openmidline Laparotomy and graham’s Omental patch repair ofduodenum perforation was done.Conclusion: The patient has been doing well since theoperation. She gave history of swallowing the Neem Twig6 Months prior to this surgery. Many a times open surgicalapproach would give a satisfactory search rather thanLaparoscopy
Description
Keywords
Foreign Body, Duodenal Perforation, Acalculous Cholecystitis
Citation
Roy Shubhrojyoti, Kar Abhimanyu, Gulati Sumit, Ghatak Supriyo. A Prospective Study of Incidence of Malignancy in Solitary Nodule of Thyroid. International Journal of Contemporary Medical Research . 2019 May; 6(5): e27-e29