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Special Feature
April 2010

Image of the Month—Diagnosis

Arch Surg. 2010;145(4):396. doi:10.1001/archsurg.2010.43-b
Answer: Foreign Body (Ingested Chicken Bone)

Multiple small-bowel adhesions with surrounding phlegmon were taken down, after which a chicken bone was found to be perforating a segment of mid-jejunum (Figure 2). The injured segment of bowel was resected and primarily anastomosed. Foreign body ingestion is a relatively common occurrence encountered by emergency department physicians. It can be seen in various scenarios: in psychiatric patients and children, intentional smuggling of drugs or other illegal substances, and simply in accidental ingestion during eating, such as in the current case.13 It is therefore an important diagnosis for the surgeon to keep in the differential in workup of the acute abdomen. The patient later recalled swallowing a chicken bone, and she fortunately had an uneventful recovery.

Figure 2.
Chicken bone. A, Foreign body (chicken bone) removed from midjejunum. B, Intraoperative photograph of perforated segment of jejunum.

Chicken bone. A, Foreign body (chicken bone) removed from midjejunum. B, Intraoperative photograph of perforated segment of jejunum.

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Article Information

Correspondence: Elliott R. Haut, MD, Division of Acute Care Surgery, Department of Surgery, The Johns Hopkins Hospital, Osler 625, 600 N Wolfe St, Baltimore, MD 21287 (ehaut1@jhmi.edu).

Accepted for Publication: April 20, 2009.

Author Contributions:Study concept and design: Barreiro and Haut. Acquisition of data: Barreiro. Analysis and interpretation of data: Barreiro. Drafting of the manuscript: Barreiro. Critical revision of the manuscript for important intellectual content: Haut. Study supervision: Haut.

Financial Disclosure: None reported.


Due to the overwhelmingly popular response to the Image of the Month, the Archives of Surgery has temporarily discontinued accepting submissions for this feature. Requests for submissions will resume in January 2011. Thank you.

Sekmen  UGungor  OSagiroglu  J Perforation of Meckel's diverticulum by a fishbone. ANZ J Surg 2008;78 (11) 1045- 1046
Serour  FWitzling  MFrenkel-Laufer  DGorenstein  A Intestinal obstruction in an autistic adolescent. Pediatr Emerg Care 2008;24 (10) 688- 690
De Jesus-Monge  WE Electronic clinical challenges and images in GI: illegal drug body packing. Gastroenterology 2008;135 (6) e1- e2