French woman perforates her bowel in 4 places

An elderly French woman perforated her bowel in four places after swallowing part of her blister pill pack.

The 72-year-old, who hasn’t been named, had swallowed the casing of her allergy tablets two weeks prior to seeking medical help.

Surgeons were forced to remove 30cm of her bowel, after scans showed the sharp edges had pinched holes in her organ.

Blister pill packs, commonly used by drug firms, are usually presented in a plastic shell enclosed by an aluminium sheet.

Once divided, portions have sharp edges that ‘constitute a risk object if swallowed’, doctors wrote in the BMJ Case Reports.

The woman is believed to be from Paimers, in the south west of France, 43 miles (69km) south of Toulouse.

Complaining of sharp stomach pains, she sought help at the Centre hospitalier du val d’Ariege, in the heart of the city.

The morbidly obese woman, who had a BMI of 46, told medics she battled the discomfort for around 15 days.

Doctors conducted several tests before choosing to send the woman for a CT scan, to examine her abdomen. They then sent her for surgery.

Surgeons operated and found four 5mm bowel perforations across the woman’s ileum – the final section of the small intestine.

An inspection of the 30cm removed portion of her ileum led surgeons to find a sharp-edged plastic foreign body.

Medics led by Dr Francesc Alari identified it to be blister pill pack foil for Atarax, an allergy drug that contains hydroxyzine dihydrochloride.

The woman recovered quickly and was allowed home six days after her surgery, according to the case report.

Dr Alari and colleagues wrote: ‘Foreign body ingestion is a relatively common problem in… paediatric patients due to inadvertent ingestion

‘Adult cases are usually related to vision problems, intellectual disability and psychiatric or cognitive disorders.’

They added that ‘intentional ingestion is usually seen in patients with psychiatric disorders or suicide attempts’.

‘Mostly, no consequences are reported,’ the medics continued. ‘But some cases can lead to complications such as perforations or gastrointestinal bleeding.

‘Endoscopic extraction may be considered when placed in the upper GI tract, but surgery remains imperative if perforation is established.’

Paperclips, fish bones, toothpicks, sewing needles are some of the most common objects that are ingested.


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