A case report of successful removal of multiples sewing needles in the gastrointestinal tract and pancreas using intraoperative C-arm fluoroscopy

Removing 216 sharp metal foreign objects from the digestive tract of a 30-year-old male: case report

Introduction and importance

Foreign body (FB) ingestion and its complications are abundant in emergency departments. This potentially severe problem had a peak incidence in children aged 6 months to 6 years. Intentional adult cases are voluntary and more common in prisoners and people with psychiatric problems. However, most patients (90%) remain asymptomatic, and these pass through the body spontaneously.

Case presentation

The authors report a case of surgically removing plenteous sharp-pointed metallic foreign bodies ingested by a young male deaf-mute bipolar schizoaffective patient from his stomach, intestine, and rectum. Furthermore, the authors have reviewed the available literature for similar cases.

Clinical discussion

Less than 1% of patients need surgical removal, 10-20% need to be taken out endoscopically, and the remaining pass spontaneously. Plain radiography is the most available imaging modality detecting the number, material, and estimated place of the alimentary canal trapped.

Conclusion

For the risk of perforation, migration, and peritonitis, surgery is indicated in such situations.

Surgical Management of Massive Metal Bezoar

Ingestion of foreign bodies is common within the pediatric population; in adults, it occurs more commonly in those with a psychiatric background. Diagnosis of such cases can be readily made based on plain abdominal X-rays. As reported, many foreign bodies pass through the gastrointestinal tract without complications, obstruction, bleeding, and perforation. The ultimate decision of the best management approach for such cases should be made based on the available expertise as well as the patient's specific factors. Observation, endoscopic removal, and surgical intervention are all acceptable approaches in cases of metal foreign body ingestion. We report a case of a 29-year-old male patient brought to the emergency department following ingestion of multiple sharp nails. He underwent surgical exploration, which resulted in the retrieval of 73 metallic nails.

Ileocecal junction perforation caused by a sewing needle in incarcerated inguinal hernia: An unusual case report

INTRODUCTION

This case study is concerning the meticulous observation of the moving process and track of 2 ingested needles using interval x-ray radiography, trying to localize the foreign bodies and reduce unnecessary exploration of digestive tract.

CASE PRESENTATION

An unusual case of a 1-year, 9-month-old female baby, with incarcerated hernia perforation caused by sewing needles with sharp ends, was reported herein. The patient had swallowed 2 sewing needles. One needle was excreted uneventfully after 8 days. On the contrary, the other needle stabbed the ileocecal junction wall into the right side of inguinal hernia sac after 9 days, and the patient received successful operation management. Interval x-ray confirmed that 1 needle-like foreign body moving down in 8 days until excretion along with feces. However, the other pierced into the incarcerated hernia. Preoperative x-ray radiography successfully monitored the moving process and tract of the sewing needles. Considering the penetrating-migrating nature of the foreign bodies, once the sharp-pointed objects were located, they should be removed as the mortality and risk of related complications may be increased.

CONCLUSION

Interval x-ray radiography represents a meticulous preoperative monitoring method of the moving process and tract of needle-like foreign bodies. Interval x-ray with real-time images accurately detecting the moving foreign bodies could be help to reduce the unnecessary exploration of digestive tract and subsequently prevent possible complications. Based on the basic findings from the interval x-ray, treatment choices of endoscopic removal and surgical intervention may be attempted.

Sewing needles in the abdominal cavity assumed to have been ingested and to have penetrated the GI tract 40 years ago: A case report

A 60-year old woman had been hospitalized in a psychiatric hospital for 40 years for schizophrenia. An X-ray was performed when she fell, which showed needles in the abdominal field. After additional examinations and questioning, the patient was diagnosed with needles in the abdominal cavity, which were assumed to have been ingested and to have perforated the GI tract 40 years ago. They were removed by laparoscopic surgery. The needles were found in the omentum and near the left ovary. There were no inflammatory reactions around them. There have been previous reports about the removal of intra-abdominal foreign bodies, but foreign body reaction occurred in most of the reports. Our case had the longest period from ingestion of the foreign bodies to their removal. Laparoscopy and intraoperative fluoroscopy are useful for removing intra-abdominal foreign bodies because of their ability to help discriminate between structures and to navigate in real time.