Transluminal migration of ingested foreign body without peritonitis

An analysis of foreign body ingestion treatment below the pylorus in children

We retrospectively studied records of patients who received conservative therapy or surgical operation for ingested foreign body (FB) located below the pylorus, and aimed to analyze the different treatment methods including prevention or operation of foreign bodies (FBs) when we found them in children of different age.The records of 16 patients (11 men and 5 women) who were hospitalized for FB ingestion between 2011 June and 2014 June were evaluated retrospectively. Mean age of the patients was 5.5 years (65.9 ± 61.0 mo). Nine patients underwent operations and 7 patients received conservative therapy. Approximately, 75% of the patients or their families recorded a positive FB swallow history. According to the results of plain radiographs, 81% patients had positive FB findings. Five patients experienced intestinal perforation. The mean duration of hospitalization was 9.13 ± 6.29 days.Intestinal perforation due to FBs is uncommon but needs to be taken into consideration especially when the FB is a magnet. It is not appropriate to give whole nuts to children (age <2 years). Radiographs should be taken 6 to 12 hours apart, and vital signs should be observed when observing a child who has ingested a sharp FB. Lastly, our society should pay more attention to psychotherapeutic needs in prepubertal children.

Extra luminal migration of ingested fish bone to the spleen as an unusual cause of splenic rupture: Case report and literature review

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Foreign body ingestion is a relatively common and benign condition; some serious complications, however, can arise.

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Approximately 1% of all ingested FB will cause perforation requiring surgical treatment.

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Sharp FB, such as fish bones, chicken bones and needles, are more prone to migrate outside the gastrointestinal lumen if they are not removed early.

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The patient reported here is the first one in the literature to present a splenic rupture due to extra-luminal migration of an ingested fish bone through the splenic flexure of the colon.

Introduction

The ingestion of foreign bodies (FB) is a common problem worldwide and affects all ages; it is, however, particularly important in the pediatric population and in mentally impaired adults. The typical outcome of FB ingestion is good, since the majority of ingested material is passed spontaneously through the gastrointestinal tract. Serious complications can occur, however, including bowel perforation or obstruction and gastrointestinal bleeding, amongst others. Extraluminal migration of ingested foreign bodies is very rare and reported cases so far have shown, more commonly, migration to neck structures, with very few reported cases of migration to the abdomen. To date, there is no reported case of extraluminal migration of ingested FB to the spleen.

Case presentation

A 59-year-old man presented with acute abdominal pain and dyspnea. A CT scan revealed a FB within the spleen, with a ruptured capsule and perisplenic collection. Surgery was performed and a 3cm-long fishbone was extracted, with hemoperitoneum secondary to spleen rupture. The patient was discharged on the third postoperative day with good recovery and without any complications; pneumococcal polysaccharide vaccination was provided.

Conclusion

FB ingestion is a relatively benign condition; however, some serious complications can arise infrequently. The patient reported herein is the first in the literature to present a splenic rupture due to extra luminal migration of an ingested fish bone.

Extraction of a foreign body in the liver using single incision laparoscopic surgery: a new application for minimally invasive surgical procedures

Ingestion of foreign bodies is a common medical problem frequently observed in children, psychiatric patients and prisoners. Various cases have been found in the medical literature, with different diagnostic and therapeutic approaches. We report a case of a 41-year-old male inmate, hospitalized for right upper quadrant pain of the abdomen due to the ingestion of two syringe needles two weeks previously. We describe the diagnostic procedure and the removal of one of the two needles that had migrated into the liver parenchyma, using a single-incision laparoscopic surgical technique. The operation was carried out safely through a 2.5 cm transverse incision below the umbilicus. The dissection and the removal of the foreign body were easily conducted under direct visualization using a minimally invasive surgical technique. Our case report demonstrates the efficacy and the security of the laparoscopic treatment in such a challenging area, employing a single port access only.

Migration of ingested sewing needle from within sigmoid colon to outside of the lumen

Foreign body ingestion is a frequently observed condition in children. However, migration of an ingested foreign body from the gastrointestinal tract toward any abdominal organ is extremely rare. We report herein a case of a 2-year-old female patient in whom an ingested sewing needle was palpable by rectal examination and was determined to have migrated from within the sigmoid colon to outside of the lumen. The needle was surgically removed. In cases of foreign body ingestion, both physical examination and radiological follow-up should be performed.

Accidental hijab pin ingestion in Muslim women: an emerging endoscopic emergency?

Ingested foreign body is an infrequent indication for emergency endoscopy in the adult gastroenterology practice. We describe the clinical features and endoscopic management of the first four cases of accidental ingestion of hijab pins by Muslim women in our unit, all presenting within a 12-month period. The pins were all successfully retrieved without any complications. In this report, we review published guidelines and the current literature, as well as discussing the approach (conservative vs proactive endoscopic retrieval) and timing of endoscopic treatment. The Muslim community may need to be alerted to the potential health hazard of hijab pins.