A Case of Sigmoid Colon Perforation Caused by Accidental Ingestion of a Press-Through Package

A 78-year-old woman was brought to our hospital by ambulance for severe abdominal pain and fever. At admission, physical examination revealed board-like rigidity with rebound tenderness over the entire abdomen. Her abdominal CT showed intraperitoneal free air and ascites in the Douglas pouch, therefore, a diagnosis of lower gastrointestinal perforation was made and emergency surgery was performed. Surgery showed the sigmoid colon had been perforated by a press-through package (PTP). Partial resection of the sigmoid colon with sigmoid colostomy was performed. There have been several reports of patients presenting with perforation of the lower digestive tract caused by PTPs. Most of them were elderly patients who accidentally ingested the PTP without realizing it. The possibility of PTP ingestion as a cause of perforation and peritonitis in the elderly should be considered.