{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T23:14:36Z","timestamp":1790982876165,"version":"4.1.0"},"reference-count":20,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"C","license":[{"start":{"date-parts":[[2022,6,1]],"date-time":"2022-06-01T00:00:00Z","timestamp":1654041600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2022,6,1]],"date-time":"2022-06-01T00:00:00Z","timestamp":1654041600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2022,5,15]],"date-time":"2022-05-15T00:00:00Z","timestamp":1652572800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Gastrointestinal tract perforation is the most harmful complication of Foreign Body (FB) ingestion, besides diagnostic delay adversely affects the outcome. This paper aims to present our preoperative diagnostic flowchart and describe the surgical management in a Tunisian center.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A retrospective review of 48 patients with gastrointestinal perforation by ingested FB treated in the surgery department of Jendouba Hospital. January 2010\u2013December 2020.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>48 patients were treated for gastrointestinal tract perforation induced by FB ingestion. The mean age was 56.6 years. The sex ratio was 2\/1. Acute abdominal pain was reported in all the patients. 35 patients had abdominal X-ray that showed a FB in 12 cases. CT scan was performed in 38 patients and identified the FB in 28 cases. Postoperative proofreading has identified a preoperative missed diagnosis of FB perforation in 5 cases, all before applying the diagnostic flowchart. All patients underwent open surgery after a median time of 7.12 h. This duration decreased after applying the flowchart (8.21 h versus 5.6 h). 33 patients had a terminal ileum perforation. Enterectomy was performed in 33 patients. Postoperatively, there was one abdominal abscess, one pulmonary embolism, one refractory septic choc, and one wound abscess. The median hospital stay was 6.35 days. The mortality rate was 6.25%. All patients managed with enterostomy had their stoma closed after 3\u20135 months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>The challenge of gastrointestinal perforation due to FB ingestion is accurate diagnosis and early management. A standardized initial assessment based on a diagnostic flowchart is helpful to achieve this goal and improve outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Highlights<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1016\/j.ijscr.2022.107216","type":"journal-article","created":{"date-parts":[[2022,5,18]],"date-time":"2022-05-18T12:12:37Z","timestamp":1652875957000},"page":"107216","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":13,"title":["Gastrointestinal perforations by ingested foreign bodies"],"prefix":"10.1097","volume":"95","author":[{"given":"Atef","family":"Mejri","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jasser","family":"Yaacoubi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed Ali","family":"Mseddi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Omry","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-66-20260304","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1016\/j.ejro.2019.04.002","article-title":"When traditions become dangerous: intestinal perforation from unusual foreign body\u2014case report and short literature review","volume":"6","author":"Simonetti","year":"2019","journal-title":"Eur. J. Radiol. Open"},{"key":"R4-66-20260304","first-page":"265","article-title":"Foreign body injuries in children: a review","volume":"35","author":"Passali","year":"2015","journal-title":"Acta Otorhinolaryngol. Ital"},{"key":"R5-66-20260304","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1007\/s00268-005-0490-2","article-title":"Perforation of the gastrointestinal tract secondary to ingestion of foreign bodies","volume":"30","author":"Goh","year":"2006","journal-title":"World J. Surg"},{"key":"R6-66-20260304","doi-asserted-by":"crossref","first-page":"7075","DOI":"10.3748\/wjg.v20.i22.7075","article-title":"Fish bone migration to the urinary bladder after rectosigmoid colon perforation","volume":"20","author":"Cho","year":"2014","journal-title":"World J. Gastroenterol"},{"key":"R7-66-20260304","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1186\/s12873-016-0104-3","article-title":"Retrospective analysis of management of ingested foreign bodies and food impactions in emergency endoscopic setting in adults","volume":"16","author":"Geraci","year":"2016","journal-title":"BMC Emergency Medicine"},{"key":"R8-66-20260304","doi-asserted-by":"crossref","first-page":"212","DOI":"10.12998\/wjcc.v1.i7.212","article-title":"Ingested bone fragment in the bowel: two cases and a review of the literature","volume":"1","author":"Emir","year":"2013","journal-title":"World J. Clin. Cases"},{"key":"R9-66-20260304","doi-asserted-by":"crossref","first-page":"6447","DOI":"10.3748\/wjg.v19.i38.6447","article-title":"Emergency admissions due to swallowed foreign bodies in adults","volume":"19","author":"Erbil","year":"2013","journal-title":"World J. Gastroenterol"},{"key":"R10-66-20260304","first-page":"869","article-title":"Swallowed foreign bodies in adults","volume":"109","author":"Ambe","year":"2012","journal-title":"Dtsch. Arztebl. Int"},{"key":"R11-66-20260304","doi-asserted-by":"crossref","first-page":"802","DOI":"10.1016\/S0016-5107(02)70407-0","article-title":"American Society for Gastrointestinal Endoscopy, guideline for the management of ingested foreign bodies","volume":"55","author":"Eisen","year":"2002","journal-title":"Gastrointest. Endosc"},{"key":"R12-66-20260304","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1016\/j.ijsu.2020.11.005","article-title":"The PROCESS 2020 guideline: updating consensus preferred reporting of case series in surgery (PROCESS) guidelines","volume":"84","author":"Agha","year":"2020","journal-title":"Int J Surg"},{"key":"R14-66-20260304","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1080\/110241500750009140","article-title":"Intestinal perforation by foreign bodies","volume":"166","author":"Madrona","year":"2000","journal-title":"Eur J Surg"},{"key":"R15-66-20260304","doi-asserted-by":"crossref","first-page":"605","DOI":"10.1007\/s00383-017-4075-6","article-title":"Intestinal perforation secondary to ingested foreign bodies: a single-center experience with 38 cases","volume":"33","author":"Lin","year":"2017","journal-title":"Pediatr. Surg. Int"},{"key":"R16-66-20260304","doi-asserted-by":"crossref","first-page":"849","DOI":"10.9738\/INTSURG-D-14-00238.1","article-title":"Laparoscopic management of complicated foreign body ingestion: a case series","volume":"100","author":"Chia","year":"2015","journal-title":"Int. Surg"},{"key":"R17-66-20260304","doi-asserted-by":"crossref","first-page":"63","DOI":"10.3348\/kjr.2009.10.1.63","article-title":"Gastrointestinal tract perforation: MDCT findings according to the perforation sites","volume":"10","author":"Kim","year":"2009","journal-title":"Korean J. Radiol"},{"key":"R18-66-20260304","doi-asserted-by":"crossref","first-page":"1119","DOI":"10.1148\/rg.264055144","article-title":"Evaluation of bowel and mesenteric blunt trauma with multidetector CT","volume":"26","author":"Brofman","year":"2006","journal-title":"Radiographics"},{"key":"R19-66-20260304","doi-asserted-by":"crossref","first-page":"3703","DOI":"10.3748\/wjg.v20.i13.3703","article-title":"Successful treatment of liver abscess secondary to foreign body penetration of the alimentary tract: a case report and literature review","volume":"20","author":"Chong","year":"2014","journal-title":"World J. Gastroenterol"},{"key":"R20-66-20260304","first-page":"558","article-title":"From interventional radiology to laparoscopic liver resection as complementary strategies in the treatment of hepatic abscess caused by ingested foreign bodies","volume":"59","author":"Riani","year":"2012","journal-title":"Hepato-Gastroenterology"},{"key":"R21-66-20260304","doi-asserted-by":"crossref","first-page":"885","DOI":"10.1007\/s11605-011-1711-7","article-title":"Pyogenic hepatic abscess secondary to endolumenal perforation of an ingested foreign body","volume":"16","author":"Glick","year":"2012","journal-title":"J. Gastrointest. Surg"},{"key":"R22-66-20260304","doi-asserted-by":"crossref","first-page":"599","DOI":"10.1155\/2005\/516195","article-title":"Management of ingested foreign bodies","volume":"19","author":"Telford","year":"2005","journal-title":"Can. J. Gastroenterol"},{"key":"R23-66-20260304","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1016\/j.ijscr.2016.08.026","article-title":"Meckel's diverticulum perforation by a fish bone: a case report","volume":"28","author":"Gon\u00e7alves","year":"2016","journal-title":"Int. J. Surg. Case Rep"}],"container-title":["International Journal of Surgery Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S221026122200462X?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S221026122200462X?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.lww.com\/10.1016\/j.ijscr.2022.107216","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T10:04:00Z","timestamp":1772618640000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1016\/j.ijscr.2022.107216"}},"subtitle":["A preoperative diagnostic flowchart-based experience. A case series report"],"short-title":[],"issued":{"date-parts":[[2022,6]]},"references-count":20,"journal-issue":{"issue":"C","published-print":{"date-parts":[[2022]]}},"URL":"https:\/\/doi.org\/10.1016\/j.ijscr.2022.107216","relation":{},"ISSN":["2210-2612"],"issn-type":[{"value":"2210-2612","type":"print"}],"subject":[],"published":{"date-parts":[[2022,6]]}}}