Introduction: Ingestion of foreign bodies has been previously reported in some patients with schizophrenia. This behavior may be a manifestation of delusional beliefs or a response to command hallucinations and can lead to severe complications.Case Presentation: This paper reports a patient with schizophrenia who, as a manifestation of his illness, ingested a metallic skewer to kill ademon inside his abdomen that he believed was controlling him. As a result, he developed an acute Intestinal perforation and underwent surgery.Conclusions: It is of a great importance to closely monitor the therapy compliance of patients suffering from mental illnesses. This will benefit them by preventing some of the serious complications of their disease, which may include life-threatening conditions such as Intestinal perforation that needs surgical intervention.

Ascariasis is a common worm infestation in developing and under-developed countries. It is caused by the ingestion of food contaminated with Ascaris eggs from faeces and is more common in places with poor sanitation. Almost 25% of the world population is infested by Ascaris lumbricoides. Although ascariasis is a chronic disease, it can present as acute abdomen rarely. The wandering nature of Ascaris in and out of the bowel causes various abdominal complications such as Intestinal obstruction, perforation, biliary ascariasis, pancreatic ascariasis, liver abscess, appendicitis, and Meckel’ s diverticulitis. Intestinal obstruction is the most common complication seen in children and is usually due to mechanical bowel obstruction, volvulus or intussusception. Mechanical obstruction by a bolus of worms is the most common cause of bowel obstruction. perforation of bowel is rarely reported and it usually occurs in the diseased segment of bowel or following trauma. perforation of an ileal volvulus secondary to ascariasis has been reported rarely. We present a 4-year-old boy who presented to the emergency room with features of bowel perforation and sepsis, after unsuccessful management for Intestinal obstruction in another hospital. On laparotomy, the small bowel was teaming with Ascaris worms. Ileum showed a volvulus with closed loop obstruction and perforation. Peritoneal lavage with resection and ileostomy was done, which was closed at a later date. Anti-helminthic agents were started postoperatively and the boy recovered uneventfully.

A 23-year-old female patient with a history of heart disease and a pacemaker for the last four years and a cesarean section 22 days ago came to the emergency department (ED) complaining of abdominal pain. Abdominal pain started seven days ago, which was vague and intermittent at first and misdiagnosed as postpartum pain in an outpatient visit. After a few days, nausea and vomiting accompanied the patient's symptoms, the abdomen became distended, and episodes of abdominal pain occurred with shorter intervals and greater intensity. The patient was referred to the ED as the abdominal pain became more severe. The initial vital signs of the patient in the ED included a blood pressure of 100/60 mmHg, a heart rate of 98 beats/minute, respiratory rate of 18 /minute, oral temperature of 37.8 Celsius, and a saturation O2 of 96% on room air.

Introduction: Hollow viscus perforation is a signifi, cant cause of surgical mortality. Various attempts have been made to identify high-risk patients preoperatively and optimize and manage such patients more aggressively. This study aimed to evaluate the predictors of outcome in patients undergoing emergency laparotomy for perforation peritonitis. Methods: This retrospective cross-sectional study was conducted on perforation peritonitis cases admitted to the Department of General Surgery, All India Institute of Medical Sciences, Rishikesh, India. The association between preoperative patient variables with postoperative complications, anastomotic leaks, need for intensive care unit (ICU) admission, and 30-day mortality were evaluated. Results: Tachycardia at the time of admission (t = 2. 443, p = 0. 020), hypotension (Â, 2 = 18. 214, p = <0. 001), lower haemoglobin (t =-4. 134, p = <0. 001), higher blood urea nitrogen levels (W = 1967. 000, p = 0. 012), International Normalised Ratio (INR) ¸,1. 5 (Â, 2 = 17. 340, p = <0. 001), the mean albumin level 2. 89 ±,0. 77 g/dL (t =-2. 348, p = 0. 027), and delay in surgery (Â, 2 = 28. 423, p = 0. 008) were signifi, cant associate factors of mortality. The association between need for ICU admission and higher pulse rate on admission (W = 2782. 500, p = 0. 011), lower systolic blood pressure (W = 1627. 500, p = 0. 029), higher blood urea nitrogen (W = 2299. 000, p = 0. 030) and serum creatinine levels (W = 2192. 500, p = 0. 045), preoperative coagulopathy (Â, 2 = 6. 773, p = 0. 017), hypoalbuminemia (t =-2. 515, p = 0. 016), and delay in surgery (Â, 2 = 17. 780, p = 0. 016) was signifi, cant. Conclusion: Based on the results of this study, hypotension, azotaemia, coagulopathy, and delay in surgery, increase the risk of postoperative mortality of patients undergoing emergency laparotomy for perforation peritonitis. Tachycardia, hypotension, azotaemia, hypoalbuminemia, and pre-operative coagulopathy were good predictors of need for ICU admission. Shock at presentation, deranged renal function and coagulopathy were associated with an increased risk of postoperative complications.

Foreign bodies ingestion is considered as a common pediatric problem, it is mostly encountred in infants between 6months and 2 years. Ingestion of magnets was documented in only few reports. We report two uncommon cases of bowel perforations owing to magnets ingestion. Patients were respectively aged of 10 months and 20 months .they were successfully managed. Once ingested, magnetic objects would attach each other through Intestinal wall leading subsequently to Intestinal necrosis. Thus their surgical removal is unavoidable.