Duodenal Foreign Body Research Articles

Lafora disease in a Chihuahua dog: a case report

The aging process is still not fully understood, although it has been studied for centuries. One of the processes in the brain during aging is the accumulation of extracellular and intracellular deposits of amyloid and lipofuscin. Deposits of various polyglucosan bodies (PGBs) are also found in brain tissue. The accumulation of the Lafora bodies (LB), a type of PGBs, can cause the Lafora disease (LD). Initial signs of the disease in humans are tonic-clonic seizures with blindness and myoclonus seizures. Normally, all haematological and biochemical indices are within the reference range in dogs with this disease. In this case, a 7-year-old Chihuahua dog with tonic-clonic seizures was presented. According to history, neurological examination, and blood test, toxic, metabolic, and infectious causes for the seizures were ruled out. The dog was started on phenobarbital 2.5 mg/kg twice daily per os. Two years later, the dog died due to complications caused by a duodenal foreign body. Postmortem examination revealed hyperaemic meninges and an enlarged, oedematous brain with flattened gyri and narrowed sulci. Histopathological examination revealed multifocal to diffuse, randomly distributed PGBs that were positive on periodic acid-Schiff (PAS) staining. The diagnosis of LD in dogs is of great importance because they are a good experimental model for neurological studies of neurodegenerative diseases in humans.

Accidental duodenal foreign body of toothbrush removed laparoscopically: a case report

BackgroundForeign body ingestion is a common case in daily medical care, and it usually passes through the entire gastrointestinal tract naturally and is excreted in the feces. However, long and sharp foreign bodies may be difficult to pass naturally due to their shape. Here, we present a rare case of a duodenal foreign body, a toothbrush, that required laparoscopic surgical removal after a failed endoscopic attempt.Case presentationA 51-year-old male with intellectual disability presented to our hospital due to fever. Initially, he was diagnosed with aspiration pneumonia by chest X-ray and blood examination. However, abdominal X-ray examination suggested a foreign body, and a computed tomography scan revealed a toothbrush in the duodenum. Therefore, upper gastrointestinal endoscopy was immediately attempted to remove it, but it could not be safely removed because the handle part of the toothbrush seemed deeply embedded in the duodenal mucosa. Therefore, this case was diagnosed as duodenal incarceration of the toothbrush, and it was removed by laparoscopic surgery. The operation was performed safely, and the patient’s postoperative course was good without any complications. The extracted toothbrush was 15 cm in length.ConclusionWe experienced a rare case of a duodenal foreign body, which was a toothbrush. The duodenal foreign body was safely removed by laparoscopic surgery for the first time.

Sepsis due to kidney injury caused by a toothpick: a case report and literature review

BackgroundToothpicks are common foreign bodies which may injure surrounding organs leading to a series of atypical symptoms. We present a rare clinical case that septicemia caused by a toothpick penetrated into the right kidney.Case presentationWe describe a 51-year-old patient who presented with right-sided backache and hematuresis for 2 days. Blood culture persistently grew Streptococcus gordonii. Ultrasound of the patient’s urinary tract revealed a strong striated echo in the middle of the right kidney. Complete abdominal computed tomography revealed a duodenal foreign body penetrating into the right kidney. The toothpick was removed under endoscopy and hemostasis was given. Antibiotic treatment was upgraded. The patient was recovered and discharged from his stay on the fifteenth day.ConclusionsEarly identification of the etiology of sepsis can effectively alleviate patient’s distress and reduce hospital stay. Clinicians should identify the source of sepsis through a medical history and examination.

Misdiagnosis of peripheral abscess caused by duodenal foreign body: a case report and literature review

BackgroundThe induction of chronic inflammation, perforation, and abscess by foreign bodies (FBs) in adults is uncommon. We present a delayed diagnosis case for a patient who had a fishbone stuck in the duodenal bulb, resulting in chronic abdominal pain for nearly 3 months. We present the diagnosis and treatment procedures for chronic patients, which differ from those for acute and emergency FB ingestion, and also summarize the characteristics of such patients through a systematic literature review.Case presentationA 68-year-old woman was brought to our hospital with repeated right upper abdominal pain lasting for 3 months and aggravation for 9 h. Computed tomography (CT) showed a streaky high-density shadow (approximately 3 cm in length) on the posterior wall of the gastric antrum extending outside the wall. Endoscopic ultrasonography showed hyperechoic space with a cross-section of approximately 0.1 × 0.1 cm in the deep submucosal layer of the local stomach, accompanied by an acoustic shadow in the rear. The possibility of a fishbone as well as perforation was considered and the object was removed using FB forceps. Fasting as well as acid inhibition and anti-infection medication were prescribed for the patient. She eventually recovered and was discharged from the hospital.ConclusionEndoscopic intervention can be recommended as the first option for patients with gastrointestinal FBs.

A5252 - Conversion of duodenal switch to gastric bypass in patient with severe malnutrition and duodenal foreign body

We present the conversion of a 100x200cm duodenal switch into a 100x70cm gastric bypass in a patient with severe malnutrition and inclusion of a foreign body in the duodenum.

Foreign body presenting as a duodenal mass: Case report and literature review

Importance: An abnormal clinical presentation of foreign body ingestion and its therapeutic approach. Review of the literature to determine rate of perforation along the gastrointestinal tract by foreign body ingestion and to identify appropriate diagnosis and treatment of ingested foreign bodies in the duodenum. Observations: A case report of a 57-year-old female presenting with abdominal pain, chest pain, and headaches for two days. With computed tomography imaging, findings of an intraluminal mass in the duodenum and retroperitoneal air were identified, leading to suspicion of a perforated duodenal malignancy. On endoscopic ultrasound, a toothpick was identified protruding through the wall of the third portion of the duodenum, which was removed by upper endoscopic forceps. A review of the literature yielded 236 cases of foreign body perforation of the gastrointestinal tract between the years 2000 to 2015 in adults 18 years and older. Perforation rate of the small bowel was highest at 39.8% followed by the duodenum 22%, colon 20.3%, sigmoid 5.5%, and unidentified site 1.7%. Literature analysis for therapeutic options for gastrointestinal injury by foreign body ingestion included endoscopy, laparotomy, or laparoscopy. A diagnostic therapeutic algorithm for duodenal foreign body ingestion was created. Conclusions: Ingested foreign bodies can present with a variety of clinical symptoms. Thus, they should be considered as part of a differential diagnosis for cases with gastrointestinal symptoms without clear etiology. Even with imaging studies, foreign body ingestion can be difficult to diagnose initially. Sharp objects, especially toothpicks, have an increased rate of perforation of the gastrointestinal tract and have a high associated morbidity and mortality. As such, prompt diagnosis and management are necessary to improve outcomes.

A Case Report of the Retrieval of a Duodenal Foreign Body from the Liver

A 27-year-old female patient from a psychiatric unit presented with a two-week history of abdominal pain and worsening nausea. She admitted to swallowing a ballpoint pen five months prior. Endoscopy showed the tip of the pen impacted in the superior wall of the first part of the duodenum. The endoscopist elected not to retrieve the foreign object and a computed tomograph (CT) was organised. This showed migration of the pen into the liver with the tip in close proximity to the portal vein. Laparoscopic surgery was performed to remove the pen with minimal blood loss. The patient was discharged 12 days later. This case highlights the presence of guidelines to aid decision-making in retrieval of ingested foreign bodies and the value of additional imaging to guide management of foreign body ingestions.

Combined endo-laparoscopic approach in a patient with a duodenal foreign body and bowel obstruction

We report the successful removal of an intraduodenal foreign body (f.b.) by endo-laparoscopic rendezvous, in a 67-year-old patient with mental disorders and duodenal occlusion by a large peach seed impacted in the duodenum. During a first endoscopic diagnostic evaluation it was possible to retract the peach seed into the stomach and have a confirmation of a stenosis of the second portion of the duodenum. Otherwise, the endoscopic procedure failed during removal out of the esophagus due to the large size of the f.b., and a second treatment in general anesthesia was planned. A 4 cm anterior gastrotomy was than performed by laparoscopy, and with a real endo-laparoscopic rendezvous, the peach seed out of the stomach was positioned, avoiding any intra-gastric surgical manouver and directly passing from Dormia basket into laparoscopic plastic retrieval bag. The gastrotomy was than closed with a single cartridge of a linear stapler and reinforced with an oversewn suture.

A case of the duodenal foreign body that right upper abdominal pain persisted

A case of the duodenal foreign body that right upper abdominal pain persisted

IMAGING DIAGNOSIS—EXTRAHEPATIC BILIARY TRACT OBSTRUCTION SECONDARY TO A DUODENAL FOREIGN BODY IN A CAT

A 13-month-old, neutered female domestic shorthaired cat was evaluated for vomiting, anorexia, and lethargy. The cat was icteric and hyperbilirubinemic. Radiographically a partially radiolucent proximal duodenal foreign body was suspected. Ultrasonographically, there was a foreign body at the level of the duodenal papilla and dilation of the common bile duct and cystic duct; a diagnosis of extrahepatic biliary tract obstruction secondary to a duodenal foreign body was made. Sonographic findings were confirmed at surgery and a duodenal foreign body was removed. This information defines duodenal foreign body as a cause of extrahepatic biliary obstruction in cats.

ガイドチューブを併用し，内視鏡的に摘出しえた食道静脈瘤合併十二指腸異物の1例

ガイドチューブを併用し，内視鏡的に摘出しえた食道静脈瘤合併十二指腸異物の1例

A CASE OF A DUODENAL FOREIGN BODY (TOOTHBRUSH) MANIFESTING ITSELF 3 YEARS AFTER SWALLOWING

We experienced an operative case of a duodenal foreign body (toothbrush) manifesting itself 3 years after swallowing.A 60-year-old woman was admitted to the hospital with the chief complaints of epigastric pain, hematemesis and bloody stool. Endoscopic examination showed a stick like foreign body in the duodenum. Attempts to remove it with forceps were unsuccessful. On questioning, she was reminded of swallowing accidentally a toothbrush 3 years before and forgot it without complains. An abdominal roentogenogram revealed that the toothbrush was wedged in the descending portion of the duodenum, and laparotomy was therefore performed.Twenty cases of toothbrush swallowing have been reported during past 20 years. Endoscopic removal or surgical operation should be undertaken because none of the toothbrushes have passed spontaneously. If long foreign bodies can fixed at the angulated portions of the duodenum, early removal should be performed, bearing in mind the risk of bleeding and perforation.

Acute Pancreatitis from a Duodenal Foreign Body in a Child

SummaryA 14‐month‐old child was admitted to the hospital with acute pancreatitis, abdominal pain, and shock. An abdominal radiograph revealed a paper clip standing out at the duodenal level. The foreign body was removed by endoscopy, revealing an edematic and hemorrhagic duodenal papilla. The patient progressed favorably after the foreign body was removed. This observation underlines the necessity of digestive transit surveillance of a foreign body that has not been endoscopically removed and the relevancy of duodenal endoscopy for acute pancreatitis of indefinite etiology.