Citation: H. EL Marmouk, D. Rajih, O. Nacir, F. Z. Lairani, A. Ait Errami, S. Oubaha, Z. Samlani, K. Krati. Clinical
Case Report: Prepyloric Abscess Secondary to Chicken Bone Ingestion. SAS J Med, 2024 May 10(5): 336-338.
336
SAS Journal of Medicine
Abbreviated Key Title: SAS J Med
ISSN 2454-5112
Journal homepage: https://saspublishers.com
Clinical Case Report: Prepyloric Abscess Secondary to Chicken Bone
Ingestion
H. EL Marmouk
1
, D. Rajih
1
, O. Nacir
1
, F. Z. Lairani
1
, A. Ait Errami
1
, S. Oubaha
2
, Z. Samlani
1
, K. Krati
1
1
Department of Gastroenterology Mohammed VI University Hospital Marrakesh, Morocco
2
Department of Physiology, Cadi Ayad University Mohammed VI University Hospital Marrakesh, Morocco
DOI: 10.36347/sasjm.2024.v10i05.008 | Received: 29.03.2024 | Accepted: 03.05.2024 | Published: 10.05.2024
*Corresponding author: H. EL Marmouk
Department of Gastroenterology Mohammed VI University Hospital Marrakesh, Morocco
Abstract Case Report
The accidental ingestion of foreign bodies is a common occurrence but can sometimes lead to serious complications,
such as gastrointestinal perforation or abscess formation. We report the case of a patient who presented with diffuse
atypical abdominal pain, accompanied by late postprandial vomiting, revealing the presence of a foreign body
transfixing the posterosuperior pyloric wall. This condition led to the formation of an abscess in this region, requiring
surgical intervention at Mohammed VI University Hospital in Marrakesh. This case highlights the potential risks
associated with the ingestion of foreign bodies and underscores the importance of prompt and appropriate management
of such complications to avoid serious consequences.
Keywords: foreign body, prepyloric abscess, abdominal CT, FOGD, surgery.
Copyright © 2024 The Author(s): This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International
License (CC BY-NC 4.0) which permits unrestricted use, distribution, and reproduction in any medium for non-commercial use provided the original
author and source are credited.
INTRODUCTION
The ingestion of foreign bodies (FB) can cause
multiple complications that can sometimes be serious. It
most commonly occurs accidentally in children and
sometimes patients with underlying mental conditions.
In adults, it is caused by poor eating habits such as eating
too quickly, coughing fits or arguments during meals [1].
The ingestion of foreign bodies can even be intentional.
The nature of foreign bodies inadvertently ingested into
the digestive tract varies widely. A foreign body can
perforate the digestive tract and cause peritonitis or an
abscess, and it can even migrate out of the digestive tract,
leading to an unexpected clinical picture [1].
We report a case of a patient who presented to
the emergency department with diffuse atypical
abdominal pain and late postprandial vomiting, revealing
the presence of a foreign body transfixing the
posterosuperior pyloric wall, an abscess collection site.
This case was treated surgically at Mohammed VI
University Hospital Center in Marrakech.
CASE REPORT
A 74-year-old man with a history of accidental
ingestion of a chicken bone two months ago presented to
the emergency department with unusual diffuse
abdominal pain associated with postprandial vomiting,
with concurrent fatigue and loss of appetite. On physical
examination, the patient was conscious, stable
hemodynamically and in terms of respiration, and
presenting epigastric tenderness without abdominal
guarding or rigidity. The rest of the examination was
normal. Blood tests revealed hyperleukocytosis at
16,600/mm3 with neutrophil predominance at
13,612/mm3, and high C-reactive protein at 54.2 mg/l.
Hemoglobin was normal at 14 g/dL, and ionogram and
renal function results were within normal limits
(Na+:142 mmol/L, K+:4.3 mmol/L, urea: 0.3 g/L,
creatinine: 10 μmol/L).
In light of this clinical picture, an abdominal
computed tomography (CT) scan was performed and
revealed the presence of a linear foreign body measuring
38 mm in length, transfixing the posterosuperior pyloric
wall which was thickened and associated with an
abscessed collection measuring 28x20 mm, with no signs
of pneumoperitoneum (Figure 1).
Gastroenterology