Skip to main content


Log in

Spiral CT and multidetector-row CT diagnosis of perforation of the small intestine caused by ingested foreign bodies

  • Gastrointestinal
  • Published:
European Radiology Aims and scope Submit manuscript


The aim of this retrospective study was to emphasize the performances of spiral CT (HCT) and multidetector-row CT (MDCT) as very effective imaging modalities for the diagnosis of intestinal perforations caused by calcified alimentary foreign bodies. Eight sites of perforations of the ileum by ingested foreign bodies were found in seven patients—one patient presenting with two separate sites of perforation. The diagnosis was successfully made by HCT in four patients and MDCT in the remaining three. Involuntarily and generally unconsciously ingested chicken and fish bones were the implicated calcified foreign bodies. The acute clinical presentations were nonspecific, mimicking more common acute abdominal conditions. A thickened intestinal segment (7/8 sites) with localized pneumoperitoneum (4/8 sites), surrounded by fatty infiltration (4/8 sites) and associated with already present or developing obstruction or sub-obstruction (5/7 patients) were the most common CT signs, but the definite diagnosis was clearly made by the identification of the calcified foreign bodies (7/7 patients). In each patient, this identification was only possible thanks to the scrupulous analysis of very thin overlapping reconstructions obtained not only in the perforation sites (6/8 sites), but also through the entire abdomen (2/8 sites). Our report emphasizes the high performances of CTA and MDCT in identifying intestinal perforation caused by calcified alimentary foreign bodies. Moreover, the high specificity of the CT diagnosis made it possible to avoid surgerical exploration in three patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others


  1. Madrona AP, Fernandez-Hernandez JA, Carasco M, Carasco Pratas M, Riquelme J, Paritta Paricio P (2000) Intestinal perforation by foreign bodies. Eur J Surg 166:307–309

    Article  PubMed  Google Scholar 

  2. Noh HM, Chew FS (1998) Small bowel perforation by a foreign body. Am J Roentgenol 171:1002

    CAS  Google Scholar 

  3. Rioux M, Langis P (1994) Sonographic detection of clinically unsuspected swallowed toothpicks and their gastrointestinal complications (1994) J Clin Ultrasound 22:483–490

    CAS  PubMed  Google Scholar 

  4. Rasheed AA, Deshpande V, Stanetz PJ (2001) Colonic perforation by ingested chicken bone. Am J Roentgenol 176:152

    CAS  Google Scholar 

  5. Maglinte DDT, Taylor SD, Ng AC (1979) Gastrintestinal perforation by chicken bones. Radiology 130:597–599

    CAS  PubMed  Google Scholar 

  6. Coulier B (1997) US diagnosis of perforating foreign bodies of the gastrointestinal tract. JBR-BTR 80:1–5

    CAS  Google Scholar 

  7. Gonzalez JG, Gonzalez RR, Patino JV, Garcia AT, Alvarez CP, Pedrosa GSA (1988) CT findings in gastrointestinal perforation by ingested fish bones. J Comput Assist Tomogr 12:88–90

    CAS  PubMed  Google Scholar 

  8. Strauss JE, Balthazar EJ, Naidich DP (1985) Jejunal perforation by a toothpick: CT demonstration. J Comput Assist Tomogr 9:812–814

    CAS  PubMed  Google Scholar 

  9. Takada M, Kashiwagi R, Sakane M, Tabata F, Kuroda Y (2000) 3D-CT diagnosis for ingested foreign bodies. Am J Emerg Med 18:192–193

    CAS  PubMed  Google Scholar 

  10. Rosen MP, Siewert B, Sands DZ et al (2003) Value of abdominal CT in the emergency department for patients with abdominal pain. Eur Radiol 13:418–424

    PubMed  Google Scholar 

  11. Taourel P, Kessler N, Lesnik A et al (2002) Non-traumatic abdominal emergencies: imaging of acute intestinal obstruction. Eur Radiol 12:2151–2160

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations


Corresponding author

Correspondence to Bruno Coulier.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Coulier, B., Tancredi, MH. & Ramboux, A. Spiral CT and multidetector-row CT diagnosis of perforation of the small intestine caused by ingested foreign bodies. Eur Radiol 14, 1918–1925 (2004).

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: