A Case of Misdiagnosis of Perforation of Sigmoid Caused by Denture Im-paction

AO Wenjing; MAN Quan; MIAO Zhuorui; PANG Huifang

doi:10.3969/j.issn.1002-3429.2025.08.004

Abstract：Objective To explore the causes of misdiagnosis and preventive measures of perforation of sigmoid colon caused by foreign body impaction in the colorectum.Methods The clinical data of 1 patient with perforation of sigmoid colon caused by foreign body impaction in the colorectum that had been misdiagnosed were retrospectively analyzed.Results A pa-tient had abdominal pain and distension after swallowing a denture by mistake 5 months before.Plain abdominal X-ray was taken at 3 d afterwards,which showed intestinal foreign bodies.One week afterwards,the plain abdominal X-ray was retaken and no abnormalities were found.It was mistakenly believed that the foreign body had been expelled.There are still intermit-tent symptoms of abdominal pain and bloating afterwards,and the patient was treated again 3 days ago due to aggravation and hematochezia.Colonoscopy,plain abdominal X-ray and abdominal CT were performed to make a preliminary diagnosis of in-complete ileus,stenosis of the colon and possible foreign body impaction.Laparotomy revealed obvious hyperemia and edema of the sigmoid colon,which involved hard foreign bodies and caused intestinal stenosis.The foreign bodies(denture)were re-moved and gas could overflow from the site of impaction.Perforation was considered,repair and suture the perforation and in-cision site were provided,and the postoperative treatment of fasting water,gastrointestinal decompression,hemostasis,anti-infection,rehydration and nutritional support were given.The recovery was good,and he was discharged on the 10th day.The misdiagnosis lasted 5 months.At 2 months after surgery,the patient was followed up by phone and reported no discomfort such as abdominal pain or bloating.The bowel movement returned to normal and the body weight was increased by 3 kg.Conclu-sion Detailed medical history and improvement of various examinations can avoid misdiagnosis and missed diagnosis of perfo-ration and serious consequences caused by foreign body impaction in the colorectum.Early diagnosis and timely treatment can ensure a good prognosis.