October 1, 2008
Consultant.
No. 11
Photoclinic
Foresee Your Next Patient
Foreign-Body Ingestion
ROBERT M. SIWIEC, MD and MARC S. FINE, MD
Advocate Lutheran General Hospital,
Park Ridge, Ill
A 74-year-old man who had Parkinson disease dementia presented with constipation and bloating associated with abdominal pain. An abdominal radiograph showed what appeared to be a small light bulb in the left upper quadrant (A). This study was compared with a film of the same patient obtained 3 years earlier that also showed a foreign body (B). There was no mention of this object in the accompanying radiology report. A CT scan of the abdomen revealed a metallic foreign body (about 2.3 x 1.2 cm) in the region of the descending portion of the duodenum. An upper endoscopy was performed. The foreign body was located in the bulb of the duodenum and was retrieved intact with a basket and overtube (C). The specimen was identified as a broken light bulb (D), with a 1 x 1-cm glass portion and 1.2 x 0.7-cm metallic portion. At follow-up, the patient’s GI symptoms had diminished.   According to his wife, the patient enjoyed taking flashlights and flashbulbs apart and putting them back together. It is possible that he had been holding the light bulb between his teeth while he worked and had accidentally ingested it.
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Photoclinic features patient photographs submitted by office-based primary care clinicians and published in Consultant. These images are chosen for their teaching value and seasonality, to help you recognize problems you might see in your own patients. Submission Guidelines for Photoclinic. |
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