Edentulism Leading to Foreign Body Ingestion with Small Bowel and Bladder Perforation: A Case Report

Introduction: Foreign body ingestion is an uncommon but recognized cause of gastrointestinal perforation. While most cases resolve without incident, complications such as enteric fistulas and organ injuries can arise in exceptional scenarios.Case Presentation: We report the case of a 42-year-old edentulous male who presented with signs of generalized peritonitis. Clinical examination revealed abdominal rigidity, and despite a CT scan identifying a linear hyperdense object within the jejunum suggestive of a foreign body, no clear signs of perforation were seen. Urgent surgical exploration revealed a chicken bone responsible for small bowel perforation, multiple entero-enteric fistulas, and a bladder injury. The patient's edentulism and financial inability to obtain dental prostheses contributed to the accidental ingestion of the bone.Management and Outcome: A segmental resection of 1.8 meters of small bowel was performed with creation of a double-barrel ileostomy. The bladder breach was identified intraoperatively using a Betadine test and repaired in two layers with Vicryl 3/0. The patient recovered well and was discharged on postoperative day five.Conclusion: This case highlights the importance of clinical judgment over imaging, especially in emergency abdominal conditions. It also underlines the significance of addressing social determinants of health, such as edentulism and poverty, in preventing life-threatening complications. Multidisciplinary collaboration, timely surgical intervention, and intraoperative vigilance were pivotal to the favorable outcome.