An ingested metallic wire migrating from stomach to pancreas treated by laparoscopic surgery: A case report

Abstract

IntroductionForeign bodies inside the pancreas are rare and usually occur after the ingestion of sharp objects such as a fish bone, a sewing needle, or a toothpick. Furthermore, an ingested metallic wire migrating from stomach to pancreas is very rare.Case PresentationWe report a 36-year-old woman who was admitted to our hospital with “3-day history of dull progressive epigastric pain.” Computed tomography of the abdomen revealed a linear, high-density body between the stomach wall and the pancreas. During the operation, a linear, hard, metallic wire was found in the adhesive tissue between the gastric antrum and the pancreatic body. The operation was uneventful, and the patient recovered well.ConclusionThe case of a foreign body inside the pancreas caused by a metallic wire is very rare. Radiological examinations play a vital role in the diagnosis of metallic wire ingestion. Metallic wire ingestion can be treated with laparoscopic surgery, both technically and safely.

Pancreatitis from posterior gastric wall perforation by ingested metallic wire—case report and review of literature

“…4 Hao et al in 2022 reported the case of 36/F presenting with dull epigastric pain, whose CT demonstrated a similar liner high density foreign body extending from the posterior gastric wall and embedded in the pancreas; a 3 cm metallic wire was removed on surgery and was assumed to have been ingested from remnants of a metallic brush used to clean pots and pans. 25 There was, however, no abscess formation/ inflammation or pancreatitis in this patient. Sulieman et al in 2022 reported a case of an accidentally ingested metallic grill brush wire masquerading as peripancreatic and paraduodenal inflammation on CT.…”

Foreign Glass Bodies in Pleura and Pancreas: Systematic Review for Entry Hypotheses and Treatment Options in an Unresolved Case

“…Another hypothesis is that the glass bodies might have taken a more distal route, such as transgastric or transenteric, from which they would have spread further within the body. It is estimated that around 1% of swallowed foreign bodies penetrate the gastric and duodenal wall, traveling within the abdominal cavity and potentially reaching the liver, pancreas, spleen or even further into the thoracic cavity 28,33 . Our literature review revealed 41 cases of intrapancreatic foreign bodies (Table 3), including 14 suture needles, 23–31 4 metal wires, 32–35 19 fish bones, 7,36–47,49–54 2 other pointed bones 55,56, and 2 toothpicks 57,58 .…”

“…There are documented cases where a substantial amount of glass shards were deliberately ingested but successfully passed through the digestive tract without perforation 90,91 . Although foreign bodies sometimes pass through the intestine within a week without complications, larger objects, and especially pointed bodies, do increase the risk of injury 4,33,92 . It is estimated that approximately 12% of esophageal perforations are attributed to the ingestion of foreign bodies 93 .…”

“… 90 , 91 Although foreign bodies sometimes pass through the intestine within a week without complications, larger objects, and especially pointed bodies, do increase the risk of injury. 4 , 33 , 92 It is estimated that approximately 12% of esophageal perforations are attributed to the ingestion of foreign bodies. 93 If the access route in our case was indeed an esophageal tear, it would mean that the glass fragments migrated either directly or transdiaphragmally into the pleura, abdomen, and thoracic wall.…”

“…It is estimated that around 1% of swallowed foreign bodies penetrate the gastric and duodenal wall, traveling within the abdominal cavity and potentially reaching the liver, pancreas, spleen or even further into the thoracic cavity. 28,33 Our literature review revealed 41 cases of intrapancreatic foreign bodies (Table 3), including 14 suture needles, [23][24][25][26][27][28][29][30][31] 4 metal wires, [32][33][34][35] 19 fish bones, 7,[36][37][38][39][40][41][42][43][44][45][46][47][49][50][51][52][53][54] 2 other pointed bones 55,56, and 2 toothpicks. 57,58 All these foreign bodies are believed to have migrated from the stomach or the duodenum.…”