Perforation of the gastrointestinal tract caused by inadvertent ingestion of blister pill packs: report of two cases diagnosed by MDCT with emphasis on maximal intensity and volume rendering reformations

• Published in: Abdominal imaging Vol. 39; no. 4; pp. 685 - 693
• Main Authors: Coulier, Bruno, Rubay, Raphael, Van den Broeck, Stephane, Azar, Afshin Rezazadeh, Maldague, Philippe, Mailleux, Patrick, Lismonde, Yorick, Bueres, Isabelle
• Format: Journal Article
• Language: English
• Published: Boston Springer US 01.08.2014; Springer Nature B.V
• Subjects: Aged, 80 and over; Case Report; Drug Packaging - instrumentation; Esophageal Perforation - diagnostic imaging; Esophageal Perforation - etiology; Esophageal Perforation - surgery; Fatal Outcome; Female; Foreign Bodies - complications; Foreign Bodies - diagnostic imaging; Foreign Bodies - surgery; Gastroenterology; Hepatology; Humans; Image Processing, Computer-Assisted; Imaging; Intestinal Obstruction - diagnostic imaging; Intestinal Obstruction - etiology; Intestinal Obstruction - surgery; Intestinal Perforation - diagnostic imaging; Intestinal Perforation - etiology; Intestinal Perforation - surgery; Intestine, Small - diagnostic imaging; Intestine, Small - injuries; Intestine, Small - surgery; Male; Mediastinitis - diagnostic imaging; Mediastinitis - etiology; Mediastinum - diagnostic imaging; Mediastinum - surgery; Medicine; Medicine & Public Health; Multidetector Computed Tomography; Radiology; Abdomen, CT; Press-through package; Blister pill pack; Esophagus perforation; Gastrointestinal tract, perforation; Small bowel obstruction; Gastrointestinal tract, foreign bodies
• ISSN: 0942-8925; 2366-004X; 1432-0509; 2366-0058
• DOI: 10.1007/s00261-014-0120-2

We report two cases of elderly patients presenting with life-threatening complications due to inadvertent accidental ingestion of blister pill packs (BPPs). The first patient presented with obstruction followed by anemia and finally perforation of the small bowel. The second presented with rapidly lethal mediastinitis due to a large perforation of the lower esophagus. The responsible BPPs were identified by multidetector computed tomography and the best result in their characterization was obtained through maximal intensity projections and volume rendering reformations.