Perforation Iléale sur un Os Ingéré, Une Cause Inhabituelle de Péritonite : À Propos d’un Cas à Libreville
DOI:
https://doi.org/10.5281/hra.v2i1.5168Keywords:
péritonite – perforation – Iléon – os pouletAbstract
RÉSUMÉ
En Afrique, la péritonite aigue est fréquemment infectieuse. Ce cas interpelle sur le danger d’un os ingéré entièrement, source peu décrite de péritonite. Un patient de 39 ans adressé pour douleur abdominale généralisée fébrile rapportait l’ingestion accidentelle d’un pilon de poulet. L’examen notait une irritation péritonéale avec au scanner un épanchement hydro-aérique péritonéale et une structure tubulaire hyperdense pelvienne. L’exploration chirurgicale retrouvait une péritonite purulente sur perforation iléale et un os dans le Douglas. Nous réalisions une suture, un lavage et drainage péritonéale. L'ingestion d’un os entier occasionne volontiers une occlusion intestinale mais doit faire craindre une péritonite.
ABSTRACT
In Africa, acute peritonitis is frequently infectious. This case raises concerns about the danger of an entirely ingested bone, a little-described source of peritonitis. A 39-year-old patient referred for generalized febrile abdominal pain reported the accidental ingestion of a chicken drumstick. The examination noted peritoneal irritation with peritoneal hydro-aerial effusion and a hyperdense pelvic tubular structure on the CT scan. Surgical exploration revealed purulent peritonitis on ileal perforation and bone in the Douglas. We performed peritoneal suturing, washing and drainage. Ingesting a whole bone often causes intestinal obstruction but should raise the risk of peritonitis.
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