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KMID : 0371320060700040317
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Journal of the Korean Surgical Society
2006 Volume.70 No. 4 p.317 ~ p.320
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Laparoscopic Removal of an Ingested Needle, which was Penerated to the Lesser Omentum of the Stomach
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최상태/Choi ST
이정남/김건국/조중연/김현철/박세훈/정민/Lee JN/Kim KK/Jo JY/Kim HC/Park SH/Chung M
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Abstract
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The perforation and migration of ingested sharp metallic bodies is a rare event. A perforation of the gastrointestinal tract is difficult to accurately and quickly diagnose when there is no peritonitis or abscess formation. Patients often present with no symptoms. The discovery of a foreign body on a radiological examination of the abdomen may be made incidentally. Moreover, a history of ingestion is usually difficult to obtain. Foreign bodies after perforation have been reported to migrate to any intra-abdominal site and to extra- abdominal sites in rare cases. We report one case of young man with ingested needle in which perforated silently and migrated to the lesser omentum. A 23-year-old man presented with an incidental foreign body. He has no definite ingestion history or psychiatric disorder, but was a heavily drinker. An abdominal plain X-ray showed a needle in the upper abdominal area. Computed tomography revealed the foreign body to be located beneath the liver and in the lesser omentum. The patient underwent a laparoscopic examination performed in the supine position. After creating a pneumoperitoneum by CO2 gas insufflation at 12 mmHg, 3 trochars (two 5-mm and 12-mm) were introduced at each subcostal and supraumbilical area. Surgical management using laparoscopic extraction was successful. The patient was discharged in good health on the 3rd day after the procedure. Laparoscopy can be used to remove ingested foreign bodies when surgery is indicated. (J Korean Surg Soc 2006;70:317-320)
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