Laparoscopic Retrieval of a 13-Year-Old Retained Iatrogenic Metallic Foreign Body from the Pelvis: An Uncommon Case Report

Abstract

Retained surgical foreign bodies are unanticipated events culminating from inadvertent operating room errors and may cause severe medical and legal problems between the patient and the doctor. Here, we report detecting a surgical instrument fragment 13 years after an open abdominal hysterectomy in a quadragenarian during her evaluation of a month-old complaint of lower abdominal and right thigh pain. A computed tomography scan of the abdomen demonstrated a radio-opaque linear foreign body traversing the right obturator foramen with extension into the pelvis cranially and the adductor compartment of the right thigh caudally. The metallic foreign body, identified as a fragmented handle of a uterine tenaculum forceps with a slender sharp-tip hook, could be removed laparoscopically from the pelvis after a diagnostic laparoscopy, preventing significant complications. The minimally invasive approach enabled a smooth recovery, and the patient could go home on the second postoperative day.

Decade Later Presentation of an Intraosseous Metallic Foreign Body in the Pelvis: A Case Report and Literature Review

“…The size and location of the foreign body also correlate to the type and duration of the symptoms. Patients can have minimal symptoms, such as palpable mass, visual difficulty, fever, or decreased joint movements [ 3 , 4 , 8 ].…”

“…A very late presentation of metallic foreign bodies has been reported in other medical fields [ 2 - 4 , 6 , 8 ]. Metallic foreign bodies lying on or inside bones mostly remain dormant for a long time.…”

“…Metallic foreign body reactions are observed many times and often within a period of a few months to a year [ 1 ]. However, the late presentations, almost a decade later, of a foreign body are very rarely seen [ 2 - 4 ]. Even though the underlying possible mechanisms were explained by some authors, they still remain unclear [ 2 ].…”

“…Military injuries are addressed by lifesaving surgeries, and at times, inactive, deep-seated foreign bodies not lodged near neurovascular or vital structures are retained [ 5 ]. Patients with retained foreign bodies may have different types of symptoms, such as pain, soft-tissue swelling, and hardware irritation [ 3 , 4 ]. Deep-seated foreign body removal surgeries involve long, extensive soft tissue dissection and, at times, failure to locate them in tissue planes [ 6 ].…”

Transperitoneal laparoscopic retrievement of a migrated prosthetic head after total hip arthroplasty: a case report

“…The use of the laparoscopic technique to explore the peritoneal cavity is a well-established practice ( 12 ). The pelvic exposure can be easily obtained through a standard periumbilical port.…”