Learning Radiology xray montage

Foreign Body (Chicken Bone) Perforation of Bowel

General Considerations

  • Overall, most ingested foreign bodies occur in children
  • Perforation occurs in less than 1% of ingested foreign bodies
  • Known agents include chicken and fish bones, toothpicks, dentures and cocktail sticks
  • Blunt foreign bodies may also perforate through a slower process of pressure necrosis of the bowel wall
  • Most patients don’t remember ingesting the foreign body
  • At greater risk are:
    • The elderly
    • Those wearing dentures
    • Patients with bowel strictures
    • Alcoholics and psychiatric patients

Clinical Findings

  • Pain
  • Nausea
  • Vomiting
  • Fever

Imaging Findings

  • CT is most useful in finding the foreign body and the reaction to them
  • Most common site of perforation is terminal ileum (83%) and colon
  • Visualization of the foreign body outside of the bowel lumen
  • Thickening of the bowel wall
  • Surrounding inflammatory reaction
  • Small amounts of loculated extraluminal air
  • Free air is not common

Differential Diagnosis

  • Appendicitis
  • Diverticulitis


  • Treatment usually involves surgical resection or repair of the bowel


  • Fistula formation
  • Inflammatory mass
  • Acute abdomen

perforation bowel from chicken bone

perforation bowel from chicken bone

Chicken Bone Perforation of Cecum. The patient had ingested chicken about a week prior. There is a calcific, curvilinear foreign body (yellow arrow) outside of the lumen with adjacent bowel wall thickening, stranding and a small amount of extra-luminal air (white arrow). The 3D color reconstruction shows the chicken bone (oval) outside of the cecum.
For these same photos without the arrows, click here and here

For more information, click on the link if you see this icon

Ulster Med J. 2007 January; 76(1): 37–38.  Bowel perforation caused by swallowed chicken bones – a case series.  S Akhtar, N McElvanna, KR Gardiner, and ST Irwin


Amjad A. Rasheed, Vikram Deshpande, Priscilla J. Slanetz. Colonic Perforation by Ingested Chicken Bone. AJR:176, January 2001;176:152 0361–803X/01/1761–152