Asian Journal of Case Reports in Surgery

Hollow viscus perforation caused by foreign body ingestion or insertion per rectally is a serious and emergency condition that requires prompt diagnosis and prompt surgical intervention. This might be challenging at times, especially in patients with psychiatric abnormality as they tend to present late and might not disclose any history of ingestion or insertion of foreign body. Our case report described a 35 years old male psychiatric patient presented with chief complains of pain abdomen, distention and non passage of stool and flatus for 2 days. Clinical and radiological examinations confirmed the presence of hollow viscus perforation. The patient underwent emergency exploratory laparotomy. On exploration there was a perforation in the second part of duodenum caused by an sharp object (pen refill) and another perforation at the sigmoid colon caused by a plastic beaded object. Primary repair of the perforated sites was done using two layers repair technique after removing the foreign body. The patient made a good post operative recovery. The patient was discharged on 8^th Post operative day after psychiatric consultation and evaluation.