A Granulomatous Liver Abscess Which Developed After a Toothpick Penetrated the Gastrointestinal Tract: Report of a Case

Kanazawa, S.; Ishigaki, Katsu; Miyake, Takashi; Ishida, Akira; Tabuchi, Atsushi; Tanemoto, Kazuo; Tsunoda, Tsukasa

doi:10.1007/s005950300071

Cited by 54 publications

(47 citation statements)

References 5 publications

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“…12,[15][16][17] All of our patients presented with nonspecific abdominal pain and normal radiographs. However, all 5 patients were subsequently found to have complicated FB ingestion secondary to fish bones.…”

Section: Discussionmentioning

confidence: 79%

Laparoscopic Management of Complicated Foreign Body Ingestion: A Case Series

Chia

Wijaya

Wong

et al. 2015

International Surgery

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This study aims to demonstrate the safety and feasibility of laparoscopic management of complicated foreign body (FB) ingestion in a series of 5 patients. We present the merits of a minimally-invasive approach in this clinical setting from our series as well as published case reports. FB ingestion is occasionally complicated by abscess formation or perforation, requiring surgical intervention. Anecdotal reports of such cases managed by laparoscopic surgery have alluded to its merits over the conventional approach of open surgery. Over an 18-month period, 5 of 256 patients with FB ingestion at our unit were managed by laparoscopic surgery. Clinical and operative data were collected for this study. In all 5 cases, patients could not recall their FB ingestion and had normal plain radiographs. The diagnosis was made on a computed tomography (CT) scan. Laparoscopy was successfully employed to retrieve all FBs (fish bones), deroof abscesses, and primarily repair gastrointestinal perforations. The mean operative time was 69 minutes (55-85), utilizing 2 to 4 noncamera ports. There was no operative mortality and patients were discharged on average postoperative day (POD) 5 (2-8). Laparoscopic surgery is safe and feasible in small-diameter, complicated FB ingestion requiring surgical intervention and should be considered in similar patients. ed FB ingestion were successfully managed with minimally-invasive surgery (MIS). [4][5][6][7][8][9][10] The potential benefits of a laparoscopic approach in abdominal surgery are well known and include reduced postoperative ileus and pain, smaller incisions and superior cosmetic results, shorter duration of hospitalization, and earlier return to work and a decreased incidence of postoperative hernias. 4,11 This paper presents the largest case series to date of 5 consecutive patients, who were managed via laparoscopic approach for complicated FB ingestion. We aim to review and report the salient clinical features of this series of patients to demonstrate that laparoscopic management is safe, feasible, and should be considered when managing FB ingestions in a similar clinical setting. Materials and MethodsOver an 18-month period, 256 patients presented with FB ingestion to our center. Of these, 5 patients were managed surgically via laparoscopic approach. Records of relevant clinical and demographic data, presenting symptoms, investigations, operative procedures, and length of hospitalization were reviewed after obtaining Institutional Review Board (IRB) approval. Operative findings and data were collected. These included FB size, location, number of ports used, and total operative time.

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Section: Discussionmentioning

confidence: 79%

Laparoscopic Management of Complicated Foreign Body Ingestion: A Case Series

Chia

Wijaya

Wong

et al. 2015

International Surgery

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“…5 Furthermore, perforation or penetration by a toothpick can be asymptomatic, and causing later complications in adjacent structures, such as, fistula involving a major blood vessel, 6 constrictive pericarditis, 7 or a liver abscess. 8 However, it is difficult to diagnose toothpick ingestion because patients are usually ignorant of having swallowed a toothpick. In one study, it was found that only 12% of patients recalled swallowing a toothpick.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic Removal of a Toothpick Impacted in the Stomach Wall by Mucosal Incision

Han

Bang

Kim

et al. 2012

Korean J Helicobacter Up Gastrointest Res

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Toothpicks are not uncommonly swallowed, and subsequently, may be impacted into gastrointestinal wall and cause morbidities, and even mortality. Therefore, the early diagnosis and immediate retrieval of an ingested toothpick is important. In many cases, endoscopic removal is attempted initially, but if this fails or a complication is encountered, surgery should be considered. The authors experienced a case of ingested toothpick penetrating the gastric wall. A 51-year-old woman visited our hospital with epigastric pain of one-week duration. Upper endoscopy revealed that the sharp end of a toothpick had been impacted into the distal antrum. Endoscopic removal using an alligator jaw forceps failed because the toothpick broke during removal and our continued attempts to extract the remnant resulted in it becoming more embedded in the stomach wall. In such circumstances, surgical treatment should be considered. However, we incised the mucosa to expose the remnant toothpick, and fortunately, we were then able to grasp and remove the toothpick using an alligator jaw forceps. We report this unusual case of a toothpick impacted in the gastric wall that was resolved endoscopically by mucosal incision. (Korean J Helicobacter Up Gastrointest Res 2012;12:276-279)

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“…We were also able to find some artifacts made by metallic foreign material or contrast media. Although there has been one case of antibiotic therapy only [2], the recommended treatment is exploratory laparotomy to drain the hepatic abscess and eliminate the foreign body if a hepatic abscess secondary to a hepatic foreign body is detected [3,9,10,16]. Despite the benign evolution, the hepatic foreign body in the present case was considered a potentially risk factor for gall bladder rupture or abscess formation because of its location, and it was therefore removed as fast as possible.…”

mentioning

confidence: 91%

“…In humans, approximately 80-90% of ingested foreign bodies entering the stomach pass uneventfully through the gastrointestinal tract within a week without being discovered [3,9,13,16]. However, an ingested foreign body may cause hemorrhage, perforation or obstruction.…”

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confidence: 99%

Metallic Foreign Body in the Liver of a Dog

Choi

Lee

Wang

et al. 2010

The Journal of Veterinary Medical Science

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ABSTRACT. A 4-year-old beagle had intermittent vomiting and weight loss for 1 month. On plain radiography, an approximately 3.5-cm, radiopaque, linear foreign body was identified in the region of the liver. On ultrasonography, a hyperechoic linear structure with reverberation was identified in the left lobe or quadrate lobe. On computed tomography(CT), a thin hyperattenuating material consistent with a metallic foreign body was identified just medial to the gall bladder. Removal of the foreign body was performed without complications. We present a rare case in which a metallic foreign body was embedded in the liver asymptomatically and found incidentally during a clinical examination performed to ascertain the cause of clinical signs.KEY WORDS: eight loss, metallic foreign body, reverberation.

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A Granulomatous Liver Abscess Which Developed After a Toothpick Penetrated the Gastrointestinal Tract: Report of a Case

Cited by 54 publications

References 5 publications

Laparoscopic Management of Complicated Foreign Body Ingestion: A Case Series

Laparoscopic Management of Complicated Foreign Body Ingestion: A Case Series

Endoscopic Removal of a Toothpick Impacted in the Stomach Wall by Mucosal Incision

Metallic Foreign Body in the Liver of a Dog

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