Perforation of the sigmoid colon by swallowed chicken bone: case reports and review of literature.

Two hundred and ninety-eight cases of intestinal perforation due to foreign bodies have been reported so far. The majority of perforations occur at narrowings and angulations. In the cases reported by McPherson, 83% of the perforation occurred in the ileum. It is more common in the elderly who wear dentures, in the mentally infirm and in chronic alcoholics. We present three cases of chicken bone perforation of the sigmoid colon with three different clinical manifestations: 1) Sigmoidovesical fistula: 2) Acute surgical abdomen; 3) Inflammatory mass. All the patients were elderly and wore dentures, which cover the important sensory area of the palate, allowing foreign bodies to pass down the gullet without being noticed. The first patient, who had a sigmoidovesical fistula, was treated with proximal colostomy and repair of the fistula. The second patient had generalized peritonitis and was treated with exteriorization of the sigmoid colon. The sigmoid colon of the third patient, who had an inflammatory mass, was resected. One patient (Case 1) died as a result of portal pyemia; Case 2 developed jaundice due to portal pyemia, but recovered; and Case 3 had an uneventful recovery.