Laparoscopic removal of an ingested foreign body and repair of colonic perforation

Successful laparoscopic repair of a large traumatic sigmoid perforation

Bowel perforation can be potentially fatal. We describe the case of a 42-year-old male who presented with severe abdominal pain following anal fisting. Clinical examination revealed tenderness of the complete abdomen with signs of peritonism. A CT-scan with rectal contrast showed a perforation of the sigmoid 40 cm above the anus. At laparoscopy, a perforation in the sigmoid colon was found and successfully repaired. Patient recovered uneventful and was discharged in 5 days. We present a unique case of a sigmoid perforation after anal fisting which was laparoscopically repaired without formation of a protective colostomy.

Laparoscopic removal of bone fragment causing localized peritonitis by intestinal perforation: a report of 2 cases

The ingestion of sharp bone structures such as fish and chicken bones could cause peritonitis by penetration of the intestinal tract. However, the precise diagnosis of this occurrence is rarely made preoperatively because most patients do not remember ingesting such materials and the clinical symptoms are usually nonspecific. Laparoscopy provides an accurate diagnosis for most conditions involving acute abdominal problems. This procedure can be used as a diagnostic tool for peritonitis due to ingested foreign bodies and become a treatment modality without requiring a laparotomy. Here, we report 2 cases in which patients presented with localized peritonitis. With the laparoscopic procedure, we found the peritonitis to be the result of sharp bones perforating the intestinal tract. The bones were successfully removed laparoscopically, and the 2 patients fully recovered without complication.

Total laparoscopic repair of sigmoid foreign body perforation

We describe the case of a 43-year-old male who presented with lower abdominal pain following rectal foreign body introduction and self-removal. Clinical examination revealed generalized peritonitis with pneumoperitoneum on Erect Chest X-ray. At laparoscopy a perforation in the sigmoid colon was found and successfully repaired. In view of contamination, the bowel proximal to the perforation was exteriorized as a loop colostomy without conversion to open laparotomy. The patient was discharged home four days later: He subsequently underwent successful reversal of his colostomy at four months. Herein we present to the best of our knowledge the first case in the literature of a successful total laparoscopic repair of sigmoid perforation resulting from transanal foreign body abuse.

Combined laparoscopic and endoscopic approach for the management of two ingested sewing needles: one migrated into the liver and one stuck in the duodenum

In this paper, we present the case of a 35-year-old Caucasian female, instituted for depression, who swallowed two sewing needles. Despite the fact that the patient on presentation was asymptomatic with a normal clinical examination and blood tests, the workup revealed a contained perforation of the upper gastrointestinal tract (GI) and a migration of one needle to the liver. Moreover, the endoscopy alone failed to remove the other needle, which was stuck in the duodenal wall and, therefore, a combined endoscopic and laparoscopic approach was successfully applied to remove both needles through the abdominal wall. The postoperative recovery was immediate and the patient was discharged after 24 hours. Our aim in this study was, to introduce a combined laparoscopic and endoscopic approach for the removal of any sharp object that gets stuck in the stomach or duodenal wall. Such a technique can be used in difficult cases where endoscopy alone fails to remove sharp objects that get stuck in the alimentary track and where the risk of complications is high. Moreover, we want to discuss the safety and efficacy of the laparoscopic approach in the management of the rare cases of migrated sharp objects from the upper GI tract to the abdominal cavity, provided there is a good preoperative localization. This combined technique has shown excellent results; it is safe and easy to perform and a laparotomy can be avoided. Moreover, the laparoscopic approach is a safe, efficient approach to remove those sharp objects that have migrated into the peritoneal cavity.

Fishbone perforation of the small bowel: laparoscopic diagnosis and laparoscopically assisted management

We report a patient with small bowel perforation caused by a piece of fishbone diagnosed by laparoscopy and treated with laparoscopically assisted surgery through a small incision. This uncommon cause of peritonitis and the role of laparoscopy for this condition are discussed.