Table 1: Case reports of ingested chicken bones in the large bowel derived from the English literature [337].

Author and countryPatientPresentationInvestigationsDiagnosisManagement

Glasson et al. [3]; Wagga Wagga, Australia70-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 junctionSubtotal colectomy with ileorectal anastomosis

Werner and Gallegos-Orozco [4]; Arizona, USA65-year-old, female(i) Fatigue
(ii) Nausea
(iii) Pyrexia
(i) Abdominal examination
(ii) Full blood count
(iii) CT
Sigmoid perforation with hepatic abscessesColonoscopy and antibiotics

McGregor et al. [5]; Kansas, USA86-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, Italy70-year-old, male(i) Severe rectal bleeding(i) Endoscopy
(ii) Colonoscopy
Bone impacted in hepatic flexureRemoval with polypectomy snare

Coyte et al. [7]; Glasgow, UK76-year-old, male(i) Abdominal pain
(ii) Vomiting
(iii) Pyrexia
(i) Erect chest X-ray
(ii) CT
Small and large bowel perforationResection of midjejunum and sigmoid

Terrace et al. [8]; Edinburgh, UK85-year-old, male(i) Left lower quadrant pain
(ii) Diarrhoea
(i) Erect chest X-ray
(ii) CT abdomen and pelvis
Sigmoid perforation with distal adenocarcinomaAnterior resection with colorectal anastomosis

Mesina et al. [9]; Craiova, Romania52-year-old, female(i) Left perianal pain with swelling
(ii) Pyrexia
(i) Physical examinationIschiorectal abscessTear-drop incision

Cardoso et al. [10]; Setubal, Portugal80-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 colonColonoscopy

Park et al. [11]; Seoul, South Korea68-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 rectumFlexible sigmoidoscopy and sucralfate enema postoperatively

Akhtar et al. [12]; Belfast, UK46-year-old, male(i) Abdominal pain
(ii) Vomiting
(i) Full blood count
(ii) Erect chest X-ray
Sigmoid perforationLaparotomy with repair of perforation

Glasson et al. [3]; Wagga Wagga, Australia70-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 junctionSubtotal colectomy with ileorectal anastomosis

Vardaki et al. [13]; Athens, Greece69-year-old, male(i) Abdominal pain(i) Full blood count
(ii) CT abdomen
Sigmoid perforation with underlying carcinomaOpen surgery

Rasheed et al. [14]; Massachusetts, USA59-year-old, male(i) Left lower quadrant pain(i) CT abdomenSigmoid perforationSurgical management

Kornprat et al. [15]; Graz, Austria82-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 wallEmergency Hartmann’s procedure with necrectomy of the abdominal wall

Clements et al. [16]; Virginia, USA66-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 colonLow anterior resection with primary anastomosis and bladder repair

Tay et al. [17]; Singapore73-year-old, male(i) Irreducible left inguinal hernia
(ii) Abdominal pain
(i) CT abdomen
(ii) Exploratory laparotomy
Perforated sigmoid colonSigmoid colectomy

Joglekar et al. [18]; Great Yarmouth, UK47-year-old, male(i) Abdominal pain
(ii) Diarrhoea
(i) Full blood count
(ii) Urine dipstick
(iii) Laparotomy
Perforated sigmoid colonRepair of perforation

Bleich [19]; Connecticut, USA54-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 diverticulumFlexible sigmoidoscopy and oral antibiotics

Brucculeri et al. [20]; Monserrato, Italy75-year-old, femaleLower abdominal pain(i) CT abdomen (with and without contrast)
(ii) Flexible sigmoidoscopy
Impacted chicken bone across the diameter of the colon wallLaser source contact and removal of divided bone with forceps

Domínguez-Jiménez and Jaén-Reyes [21]; Andujar, Spain79-year-old, femaleAsymptomatic, presenting for programmed colonoscopy(i) Colonoscopy
(ii) Subsequent CT abdomen
Perforated sigmoid diverticulum with thickening of the right pelvic fasciaConservative management—patient expelled bone in faeces after 2 months

Khan et al. [22]; Craigavon, Northern Ireland56-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 wallSurgical exploration with resection of perforated bowel

Lubel and Wiley [23]; Woodville South, Australia54-year-old, female(i) Persistent lower abdominal pain
(ii) Rectal mucous
(i) ColonoscopyChicken bone impacted in inflamed diverticulaLaparotomy with sigmoid resection

Mapelli et al. [24]; Louisiana, USA72-year-old, female(i) Left lower quadrant pain
(ii) Anorexia
(i) Abdominal ultrasound
(ii) Colonoscopy
Perforation of the sigmoid colonResection of the sigmoid colon

Milivojevic et al. [25]; Belgrade, Serbia75-year-old, female(i) Nausea
(ii) Left lower quadrant pain
(iii) Fever
(i) Abdominal X-ray
(ii) Colonoscopy
Impacted chicken bone in the sigmoid colonColonoscopy

Owen et al. [26]; London, UK65-year-old, male(i) Severe lower abdominal pain
(ii) Dehydration
(iii) Pyrexia
(i) Erect chest X-ray
(ii) CT abdomen
(iii) Laparoscopy
Sigmoid perforationColonoscopy with insertion of abdominal drain

Rabb et al. [27]; South Yorkshire, UK69-year-old, male(i) Asymptomatic
(ii) Bowel cancer screening (positive for faecal occult blood)
(i) ColonoscopyImpaction of chicken bone in bowel diverticulumLaparoscopic sigmoid colectomy

Rex and Bilotta [28]; Indiana, USA73-year-old, male(i) Lower abdominal pain(i) ColonoscopyImpacted chicken bone across two diverticulaColonoscopy

Rex and Bilotta [28]; Indiana, USA81-year-old, female(i) Lower abdominal pain
(ii) Positive faecal occult blood
(i) Barium enema
(ii) Colonoscopy
Impacted chicken bone in sigmoid diverticulaColonoscopy

Tarnasky et al. [29]; North Carolina, USA80-year-old, female(i) Chronic diarrhoea
(ii) Positive faecal occult blood
(i) Abdominal examination
(ii) Colonoscopy
Perforated sigmoid colon, due to impacted chicken boneColonoscopy

Chen et al. [30]; Sydney, Australia84-year-old, female(i) Lower abdominal pain(i) Colonoscopy
(ii) CT abdomen
Impacted chicken bone across the diameter of the colon lumenNd:YAG laser/colonoscopy

Ross et al. [31]; Glasgow, UK87-year-old, female(i) Severe bleeding per anus(i) CT abdomen with angiogramImpacted chicken bone in sigmoid diverticulum with arterial bleedingFlexible sigmoidoscopy

Elmoghrabi et al. [32]; Michigan, USA70-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 boneResection of the rectum and distal sigmoid colon

Davies [33]; Cardiff, UK31-year-old, male(i) Severe rectal pain(i) Abdominal X-rayPerforated rectum immediately proximal to anal marginDigital removal followed by proctosigmoidoscopy

Jeen et al. [34]; Seoul, South Korea73-year-old, female(i) Abdominal cramping
(ii) Diarrhoea
(i) ColonoscopyChicken bone impaction in the sigmoid colon across the lumen diameterBalloon dilatation and extraction

Osler et al. [35]; New York, USA78-year-old, female(i) Abdominal pain
(ii) Nausea
(iii) Vomiting
(i) CT abdomen
(ii) Exploratory laparotomy
Sigmoid perforation distal to colonic carcinomaHartmann’s resection with end sigmoid colostomy

Moreira et al. [36]; Pennsylvania, USA31-year-old, male(i) Pain around the anal canal and scrotum
(ii) Pyrexia
(i) Open surgeryNecrotising fasciitis with perianal and scrotal abscessesDebridement and antibiotic therapy

Muñoz et al. [37]; Baracaldo, Spain67-year-old, male(i) Left lower quadrant abdominal pain
(ii) Tenesmus
(i) Abdominal X-ray
(ii) Barium enema
Impacted chicken bone in the sigmoid colonColonoscopy