Unusual cause for small bowel obstruction

Foreign body ingestion is a common occurrence. Although over 80% of ingestions resolve spontaneously, approximately 1% of cases will require open surgical intervention. We present a rare case of foreign body ingestion in an 18-year-old man causing distal mechanical small bowel obstruction, requiring exploratory laparotomy and enterotomy. An 18-year-old man with no significant medical history and no previous abdominal operations presented to a regional hospital with a 5-day history of persistent nausea, vomiting, absolute constipation and generalised abdominal pain. On clinical examination, he was tachycardic (116 beats/min) with a low-grade temperature (37.8°C), and had abdominal distension with central abdominal guarding. Plain films showed dilated loops of small bowel, consistent with small bowel obstruction. White cell count was 7.5×109/L and C reactive protein was 74 mg/L. Subsequent evaluation with a CT scan demonstrated appearance of …