|
| Author and country | Patient | Presentation | Investigations | Diagnosis | Management |
|
| Glasson et al. [3]; Wagga Wagga, Australia | 70-year-old, male | (i) Abdominal pain
(ii) Weight loss
(iii) Altered bowel habits | (i) Full blood count
(ii) CT abdomen
(iii) Abdominal X-ray
(iv) Laparotomy | Perforated sigmoid diverticulum with fibrous adhesions to the ileocaecal junction | Subtotal colectomy with ileorectal anastomosis |
|
| Werner and Gallegos-Orozco [4]; Arizona, USA | 65-year-old, female | (i) Fatigue
(ii) Nausea
(iii) Pyrexia | (i) Abdominal examination
(ii) Full blood count
(iii) CT | Sigmoid perforation with hepatic abscesses | Colonoscopy and antibiotics |
|
| McGregor et al. [5]; Kansas, USA | 86-year-old, male | (i) Left-sided abdominal pain
(ii) Vomiting
(iii) Anorexia | (i) Abdominal X-ray
(ii) Colonoscopy | (i) Sigmoid perforation with peritonitis and adhesions
(ii) Underlying adenocarcinoma | Sigmoid resection with end colostomy and Hartmann’s pouch |
|
| Girelli and Colombo [6]; Arsizio, Italy | 70-year-old, male | (i) Severe rectal bleeding | (i) Endoscopy
(ii) Colonoscopy | Bone impacted in hepatic flexure | Removal with polypectomy snare |
|
| Coyte et al. [7]; Glasgow, UK | 76-year-old, male | (i) Abdominal pain
(ii) Vomiting
(iii) Pyrexia | (i) Erect chest X-ray
(ii) CT | Small and large bowel perforation | Resection of midjejunum and sigmoid |
|
| Terrace et al. [8]; Edinburgh, UK | 85-year-old, male | (i) Left lower quadrant pain
(ii) Diarrhoea | (i) Erect chest X-ray
(ii) CT abdomen and pelvis | Sigmoid perforation with distal adenocarcinoma | Anterior resection with colorectal anastomosis |
|
| Mesina et al. [9]; Craiova, Romania | 52-year-old, female | (i) Left perianal pain with swelling
(ii) Pyrexia | (i) Physical examination | Ischiorectal abscess | Tear-drop incision |
|
| Cardoso et al. [10]; Setubal, Portugal | 80-year-old, male | (i) Vomiting
(ii) Diarrhoea
(iii) Pyrexia | (i) Full blood count
(ii) Abdominal ultrasound
(iii) CT | Hepatic abscess, bone located in the ascending colon | Colonoscopy |
|
| Park et al. [11]; Seoul, South Korea | 68-year-old, female | (i) Anal pain and bleeding
(ii) Constipation | (i) Digital rectal examination
(ii) Abdominal X-ray
(iii) CT abdomen and pelvis | Stercoral ulcer of the rectum | Flexible sigmoidoscopy and sucralfate enema postoperatively |
|
| Akhtar et al. [12]; Belfast, UK | 46-year-old, male | (i) Abdominal pain
(ii) Vomiting | (i) Full blood count
(ii) Erect chest X-ray | Sigmoid perforation | Laparotomy with repair of perforation |
|
| Glasson et al. [3]; Wagga Wagga, Australia | 70-year-old, male | (i) Abdominal pain
(ii) Weight loss
(iii) Altered bowel habits | (i) Full blood count
(ii) CT abdomen
(iii) Abdominal X-ray
(iv) Laparotomy | Perforated sigmoid diverticulum with fibrous adhesions to the ileocaecal junction | Subtotal colectomy with ileorectal anastomosis |
|
| Vardaki et al. [13]; Athens, Greece | 69-year-old, male | (i) Abdominal pain | (i) Full blood count
(ii) CT abdomen | Sigmoid perforation with underlying carcinoma | Open surgery |
|
| Rasheed et al. [14]; Massachusetts, USA | 59-year-old, male | (i) Left lower quadrant pain | (i) CT abdomen | Sigmoid perforation | Surgical management |
|
| Kornprat et al. [15]; Graz, Austria | 82-year-old, female | (i) Sepsis
(ii) Severe abdominal pain | (i) Full blood count
(ii) CT abdomen and pelvis | Perforated sigmoid diverticulum; phlegmonous inflammation of the abdominal wall | Emergency Hartmann’s procedure with necrectomy of the abdominal wall |
|
| Clements et al. [16]; Virginia, USA | 66-year-old, male | (i) Sepsis
(ii) Anuria | (i) Urine/blood cultures
(ii) Renal ultrasound
(iii) CT KUB
(iv) Colonoscopy | Colovesical fistula with submucosal/intramural haemorrhage in the sigmoid colon | Low anterior resection with primary anastomosis and bladder repair |
|
| Tay et al. [17]; Singapore | 73-year-old, male | (i) Irreducible left inguinal hernia
(ii) Abdominal pain | (i) CT abdomen
(ii) Exploratory laparotomy | Perforated sigmoid colon | Sigmoid colectomy |
|
| Joglekar et al. [18]; Great Yarmouth, UK | 47-year-old, male | (i) Abdominal pain
(ii) Diarrhoea | (i) Full blood count
(ii) Urine dipstick
(iii) Laparotomy | Perforated sigmoid colon | Repair of perforation |
|
| Bleich [19]; Connecticut, USA | 54-year-old, female | (i) Left lower quadrant pain
(ii) Pyrexia | (i) Full blood count
(ii) CT abdomen (IV and oral contrast) | Impacted chicken bone in sigmoid diverticulum | Flexible sigmoidoscopy and oral antibiotics |
|
| Brucculeri et al. [20]; Monserrato, Italy | 75-year-old, female | Lower abdominal pain | (i) CT abdomen (with and without contrast)
(ii) Flexible sigmoidoscopy | Impacted chicken bone across the diameter of the colon wall | Laser source contact and removal of divided bone with forceps |
|
| Domínguez-Jiménez and Jaén-Reyes [21]; Andujar, Spain | 79-year-old, female | Asymptomatic, presenting for programmed colonoscopy | (i) Colonoscopy
(ii) Subsequent CT abdomen | Perforated sigmoid diverticulum with thickening of the right pelvic fascia | Conservative management—patient expelled bone in faeces after 2 months |
|
| Khan et al. [22]; Craigavon, Northern Ireland | 56-year-old, male | (i) Painful haematuria
(ii) Polyuria
(iii) Pneumaturia | (i) Urine culture
(ii) IV urogram
(iii) CT scan
(iv) Cystoscopy | Colovesical fistula, secondary to perforated colon wall | Surgical exploration with resection of perforated bowel |
|
| Lubel and Wiley [23]; Woodville South, Australia | 54-year-old, female | (i) Persistent lower abdominal pain
(ii) Rectal mucous | (i) Colonoscopy | Chicken bone impacted in inflamed diverticula | Laparotomy with sigmoid resection |
|
| Mapelli et al. [24]; Louisiana, USA | 72-year-old, female | (i) Left lower quadrant pain
(ii) Anorexia | (i) Abdominal ultrasound
(ii) Colonoscopy | Perforation of the sigmoid colon | Resection of the sigmoid colon |
|
| Milivojevic et al. [25]; Belgrade, Serbia | 75-year-old, female | (i) Nausea
(ii) Left lower quadrant pain
(iii) Fever | (i) Abdominal X-ray
(ii) Colonoscopy | Impacted chicken bone in the sigmoid colon | Colonoscopy |
|
| Owen et al. [26]; London, UK | 65-year-old, male | (i) Severe lower abdominal pain
(ii) Dehydration
(iii) Pyrexia | (i) Erect chest X-ray
(ii) CT abdomen
(iii) Laparoscopy | Sigmoid perforation | Colonoscopy with insertion of abdominal drain |
|
| Rabb et al. [27]; South Yorkshire, UK | 69-year-old, male | (i) Asymptomatic
(ii) Bowel cancer screening (positive for faecal occult blood) | (i) Colonoscopy | Impaction of chicken bone in bowel diverticulum | Laparoscopic sigmoid colectomy |
|
| Rex and Bilotta [28]; Indiana, USA | 73-year-old, male | (i) Lower abdominal pain | (i) Colonoscopy | Impacted chicken bone across two diverticula | Colonoscopy |
|
| Rex and Bilotta [28]; Indiana, USA | 81-year-old, female | (i) Lower abdominal pain
(ii) Positive faecal occult blood | (i) Barium enema
(ii) Colonoscopy | Impacted chicken bone in sigmoid diverticula | Colonoscopy |
|
| Tarnasky et al. [29]; North Carolina, USA | 80-year-old, female | (i) Chronic diarrhoea
(ii) Positive faecal occult blood | (i) Abdominal examination
(ii) Colonoscopy | Perforated sigmoid colon, due to impacted chicken bone | Colonoscopy |
|
| Chen et al. [30]; Sydney, Australia | 84-year-old, female | (i) Lower abdominal pain | (i) Colonoscopy
(ii) CT abdomen | Impacted chicken bone across the diameter of the colon lumen | Nd:YAG laser/colonoscopy |
|
| Ross et al. [31]; Glasgow, UK | 87-year-old, female | (i) Severe bleeding per anus | (i) CT abdomen with angiogram | Impacted chicken bone in sigmoid diverticulum with arterial bleeding | Flexible sigmoidoscopy |
|
| Elmoghrabi et al. [32]; Michigan, USA | 70-year-old, female | (i) Lower abdominal, pelvic, and rectal pain | (i) Abdominal X-ray
(ii) CT abdomen/pelvis | Large rectal stricture secondary to impacted chicken bone | Resection of the rectum and distal sigmoid colon |
|
| Davies [33]; Cardiff, UK | 31-year-old, male | (i) Severe rectal pain | (i) Abdominal X-ray | Perforated rectum immediately proximal to anal margin | Digital removal followed by proctosigmoidoscopy |
|
| Jeen et al. [34]; Seoul, South Korea | 73-year-old, female | (i) Abdominal cramping
(ii) Diarrhoea | (i) Colonoscopy | Chicken bone impaction in the sigmoid colon across the lumen diameter | Balloon dilatation and extraction |
|
| Osler et al. [35]; New York, USA | 78-year-old, female | (i) Abdominal pain
(ii) Nausea
(iii) Vomiting | (i) CT abdomen
(ii) Exploratory laparotomy | Sigmoid perforation distal to colonic carcinoma | Hartmann’s resection with end sigmoid colostomy |
|
| Moreira et al. [36]; Pennsylvania, USA | 31-year-old, male | (i) Pain around the anal canal and scrotum
(ii) Pyrexia | (i) Open surgery | Necrotising fasciitis with perianal and scrotal abscesses | Debridement and antibiotic therapy |
|
| Muñoz et al. [37]; Baracaldo, Spain | 67-year-old, male | (i) Left lower quadrant abdominal pain
(ii) Tenesmus | (i) Abdominal X-ray
(ii) Barium enema | Impacted chicken bone in the sigmoid colon | Colonoscopy |
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