Presentation
Acute abdominal pain of two days duration.
Patient Data
A linear hyperdense object (HU=345) in an inflamed small bowel loop located in the center of the abdomen with fat stranding and a mild amount of free abdominal fluid centered more in the perihepatic spaces. The object tip looks sharp and penetrates the related bowel loop. No pneumoperitoneum. Feature consistent with intestinal perforation by a foreign body.
Photo from the surgery that proved a sharp woody object (possibly immersed toothpick) perforating the intestinal wall.
Case Discussion
Because of its porous nature and intrinsic composition, wood foreign bodies may contain tiny air bubbles and oils. Thus, they can mimic air and fat on CT and often have negative Hounsfield units (e.g., Hounsfield units of dry and fresh pin–650 and –24, respectively) 1-4. As the woody foreign body absorbs more water from its surroundings, it may become denser on CT, mimicking soft tissue 2 .
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