Intra-abdominal Foreign Body Research Articles

Polymer clip granuloma mimicking lymph node recurrence: a case report

BackgroundForeign body granulomas are postoperative inflammatory reactions to surgical materials within the body. Traditionally, sutures have been the leading cause of foreign body granulomas in the abdomen, commonly referred to as “suture granuloma”. However, the use of polymer clips in modern surgeries has introduced new challenges, and reports of intra-abdominal foreign body granulomas caused by surgical clips are limited. Herein, we present a case of an intra-abdominal foreign body granuloma formed due to polymer clips.Case presentationA 45-year-old woman who underwent laparoscopic resection for sigmoid colon adenocarcinoma subsequently developed a suspected lymph node recurrence during follow-up. Imaging showed an enlarging mass adjacent to the inferior mesenteric artery with increased fluorodeoxyglucose uptake. Laparoscopic surgical resection revealed the formation of a foreign body granuloma in response to the polymer clips.ConclusionsThis case suggests that nonabsorbable polymer clips can induce granulomatous reactions postoperatively, and the appearance of lymph node recurrence may be foreign body granulomas.

Acute Appendicitis due to Retained Intra-Abdominal Foreign Body: Case Report

Acute Appendicitis due to Retained Intra-Abdominal Foreign Body: Case Report

Evaluation of Our Cases of Foreign Body in Various Anatomical Regions of the Body

Aim: It can be quite difficult to remove foreign bodies located within soft tissue. The location needs to be defined for the procedure to be successful. The aim of this study was to present our cases where a foreign body had been detected and then removed from various anatomical regions. Material and Method: This article is about the evaluation results of our foreign body cases referred to the Kafkas University Faculty of Medicine from the Family Medicine practices in Kars and the surrounding regions. The charts of 15 patients who had presented to the General Surgery or Orthopedics and Traumatology Departments of the Kafkas University Faculty of Medicine after being referred from the emergency or outpatients departments between November 2015 and July 2019 were retrospectively reviewed. The demographic findings, surgical treatment and results, etiological causes and postoperative complications of the patients were recorded. Follow-up duration was 6 months to 3 years depending on the patient's condition. Results: There were 8 male and 7 female patients. The mean age was 30.79 years. The symptoms were pain, redness, swelling, itching and serous or purulent discharge for foreign bodies in the hand, foot, femur-tibia soft and bone tissue areas and acute abdomen symptoms in the patient where we found an intra-abdominal foreign body. The imaging methods used were conventional radiography and computed tomography. Treatments included removal of needle from soft tissue, bullet fragment from bone intramedullary tissues and intrauterine device from transverse colon meso. We also observed the rectal passage with feces of an intestinal intraluminal metallic device after it was swallowed. There was only one complication among all our patients and consisted of partial radial nerve damage. Conclusion: Foreign bodies should be located with imaging methods and removed under sterile conditions in the operating room. Early detection and removal of foreign bodies from anatomical regions are vital. Key Words: Foreign body, Radio-opaque, Soft Tissue DOI: 10.7176/JSTR/7-04-01

Extraction of foreign body from the liver via laproscopic surgery

Ingestion of foreign body is a common medical problem frequently encountered in the emergency room. Peadiatric, psychiatric patients and prisoners are the most common population suffering from accidental or in some cases intentional ingestion of foreign body. Commonly majority of cases require no surgical intervention and the swallowed object passes through digestive tract spontaneously without causing any significant complications. Less than 1% of the cases complicate gastrointestinal tract perforation, which are often caused by sharp objects which warrants surgical intervention. A 23 hear old male patient was admitted to our hospital with a complain of pain abdomen . He got an abdominal xray and a CECT scan of the abdomen done which revealed a large foreign body in his liver . The patient had a history of fall 5 months back and started having abdominal pain for which he went to the local doctor, got some antispasmodics and was relieved of the pain. So we planned a laparoscopic removal of the foreign body which was successful and the postoperative recovery was uneventful. So we reported a laparoscopic approach to be safe and feasible for the removal of intraabdominal foreign body.

Intraabdominal Foreign Body Granuloma Caused by Surgical Suture Mimicking Peritoneal Meatastasis—Report of a Case—

Intraabdominal Foreign Body Granuloma Caused by Surgical Suture Mimicking Peritoneal Meatastasis—Report of a Case—

A Case of Intra-abdominal Foreign Body that Had Directly Penetrated into Abdominal Cavity Removed by Laparoscopic Surgery

A Case of Intra-abdominal Foreign Body that Had Directly Penetrated into Abdominal Cavity Removed by Laparoscopic Surgery

Anidulafungin increases the antibacterial activity of tigecycline in polymicrobial Candida albicans/Staphylococcus aureus biofilms on intraperitoneally implanted foreign bodies.

We aimed to establish a novel murine intra-abdominal foreign body infection model to study the activity of anidulafungin and tigecycline against dual species Candida albicans/Staphylococcus aureus biofilms. In vitro and in vivo single and dual species biofilms were developed inside serum-coated triple-lumen catheters placed in 24-well plates or implanted intraperitoneally in BALB/c mice. The effect of tigecycline and anidulafungin alone and in combination was tested using clinically relevant concentrations. Scanning electron microscopy was used to visualize the mature biofilm structure developed intraperitoneally. Flow cytometry was used to determine the immunological response upon infection. Immunoblot analysis allowed us to determine the effect of anidulafungin on poly-β-(1,6)-N-acetylglucosamine in in vitro-grown S. aureus biofilms. We determined the MIC, MBC and in vitro susceptibility profile for anidulafungin and tigecycline against C. albicans and S. aureus in mixed and single species biofilms. We demonstrated that anidulafungin acts synergistically when combined with tigecycline against in vivo intra-abdominal biofilms. Moreover, we reveal that anidulafungin reduces the abundance of S. aureus poly-β-(1,6)-N-acetylglucosamine. The influx of neutrophils is much increased when infected with mixed biofilms compared with single species biofilms. Currently, treatment of intra-abdominal infections, in particular polymicrobial catheter-associated peritonitis, is ineffective. To the best of our knowledge, this is the first study that provides insight into new possible options for treatment of C. albicans/S. aureus biofilms present in the abdominal cavity.

Two Cases of an Intraabdominal Foreign Body Identified as a Piece of Metal

Two Cases of an Intraabdominal Foreign Body Identified as a Piece of Metal

Abdominal Gossypiboma: A Diagnostic Dilemma in Late Postoperative Period

Abstract: We reported a case of gossypiboma in 59-year old woman who presented with vague abdominal pain since her cesarean section and described her plain radiograph and abdominal CT scan. Keywords: Gossypiboma Introduction: 59-year old woman was admitted in our emergency department because of long lasting vague abdominal pain. She had occasionally nausea and vomiting however with no weight loss. Her past medical history was unremarkable except for cesarean section performed 15 years ago. On physical examination mild periumbilical tenderness was found and routine lab data showed no abnormality. Plain abdominal radiograph was performed which showed linear metallic density in the midpart of abdomen (Figure 1). Abdominal CT scan showed a well-defined mass like structure in RT sided abdominal cavity with no peripheral fat stranding with metallic artifact within it (Figure 2). Diagnosis of gossypiboma was made preoperatively. Surgery was done which revealed surgical sponge within abdominal cavity. The patient’s symptom resolved after surgery. Gossypiboma is a term used for description of any surgical substance remained within the body with retained surgical cotton or sponge as the commonest reported intra-abdominal foreign body. For many years they can be unnoticed until they lead to complications [1]. Gossypiboma is an avoidable condition should be considered in any postoperative patient who presents with unusual manifestation as it can be misdiagnosed and unnecessary procedure may be done [2]. In spite of its rarity in clinical practice in any patient with previous history of laparotomy should be considered as one of differential diagnosis [3]. It can cause significant morbidity or even mortality for patients and most patients with gossypiboma of abdomen are symptomatic and present with nonspecific abdominal pain [4]. Retained surgical sponge or gossypiboma is a serious unusual condition with medicolegal effect that its frequency is difficult to estimate however seems to be 1 in 1000 to 1500 intra-abdominal operations. The gossypiboma even if aseptic can induce foreign body reaction and mimic a soft tissue neoplasm and usually misinterpreted preoperatively due to low clinical and even radiological suspicious [5]. It can be anywhere in the body with intra-abdominal location as the most common site but unusual location such as paraspinal muscle, shoulder and intrathoracic region also have been reported. They usually diagnosed with radiological examination as radio-opaque density within surgical sponge help diagnosis easily however radiolucent density cause dilemma for correct diagnosis. CT scan may be needed especially in chronic presentation as they can present like a soft tissue neoplasm which revealed hypodense structure with peripheral thick rim [6]. Various imaging appearances present depending on time of retention and surgical site. They can be seen as sponge-like appearance due to bacterial overgrowth within surgical sponge and whirl like structure. In MRI, in T2 weighted sequence, folded fabric structure demonstrated. Negative uptake in scintigraphy study help in differentiation of same appearance soft tissue tumors from gossypiboma in equivocal cases [7,8]. Other radiologic characteristics in acute post-operative phase may mimic hematoma, abscess or seroma formation but in chronic phase they may be confused with chronic granulomatous reaction or soft tissue tumors[7]. Sarcoma may arise from gossypiboma in rare frequency when retention time is more than 20 years so it is necessary for careful examination of gossypiboma resected specimen for rule out of coexisting sarcoma [8]. It is preventable event with staff change avoidance during surgery and strict swab count. Minimally invasive procedures also help in decreasing its incidence [9]. Conclusion: Gossypiboma is an avoidable condition that should be considered in differential diagnosis of any patient with previous history of operation with unusual presentation in acute or chronic states.

Case Report: Intestinal Obstruction Secondary to an Intra-Abdominal Foreign Body

According to literature, the incidence of intestinal obstruction caused by internal abdominal hernia is very rare and has an occurrence rate of about 0.2-0.9%. Internal hernias are caused by defects that occur congenitally or as a result of surgery or trauma. It is still rarer for surgical instruments inadvertently left in the abdominal cavity after laparotomy to be the cause of internal herniation resulting in intestinal obstruction. A case of intestinal obstruction caused by an artery forceps left in the abdominal cavity after surgery is presented

AN INTRA - ABDOMINAL FOREI GN BODY FOUND 11 YEARS AFTER SURGERY: A RARE CASE REPORT

A retained foreign body in the abdominal cavity following surgery is a continuing problem. Incidence of such accidental revelation of intra-abdominal foreign body reported in the literature is 0.3-1 %1.

Late Presentation of Intra-abdominal Foreign Body following Caesarean Delivery: A Case Report

This is a case of delayed wound healing following a caesarean delivery conducted in a peripheral hospital two years ago. Diagnosis of foreign body was also delayed until the foreign body self extrude through a discharging sinus. Abdominal exploration revealed gauze of about 50 cm long encapsulated within the peritoneal cavity. There should be high index of suspicion of retained foreign body in delayed wound healing following a surgery even when radiological investigations were negative particularly were postoperative report was not available.Key Words retained foreign body, abscess, Caesarean delivery

Use of tamoxifen in a German shepherd dog with sclerosing encapsulating peritonitis

A German shepherd dog was diagnosed with sclerosing encapsulating peritonitis after an episode of peritonitis caused by a free intra-abdominal foreign body (stick). The foreign body had initially been treated by surgical removal and abdominal lavage. Postoperatively, peritoneal effusion persisted despite the use of methylprednisolone for 1 month and a second surgical exploration and abdominal lavage. After a third surgery at our institution (to breakdown abdominal adhesions) followed by open abdominal drainage, treatment with tamoxifen orally was initiated and within 2 weeks the dog's condition improved dramatically. Two months later, no fluid was present in the abdomen. The only apparent adverse reaction to tamoxifen therapy was swelling of the vulva. In humans, sclerosing encapsulating peritonitis is a known life-threatening complication following peritoneal dialysis. In veterinary medicine, most animals with sclerosing encapsulating peritonitis die because of chronic weight loss, peritoneal effusion and progression of concurrent disease. This dog's condition was unresponsive to methylprednisolone alone but was successfully treated with aggressive surgery including enterolysis and open abdominal lavage and the addition of tamoxifen.

RETAINED FOREIGN BODIES

Objectives: (1) To look into clinical presentations of intra-abdominal foreign bodies; (2) To document surgical procedure performed. (3) To see measures for prevention. Design: Observational case series. Setting: Bahawal Victoria Hospital Bahawalpur. Period: From 1.06.07 to 31.5.08. Patient & Methods: Eleven patients with retained having intra-abdominal foreign body were treated. Relevant history, clinical examination and necessary investigations were done. Exploratory laparotomy was done in 10 cases to remove the foreign body and in one case foreign body passed from the rectum without laparotomy. Results: Out of 11 cases, 54.54% are males and 45.45% were females. Operated in emergency 81.81% and elective 18.18%. 90.91% were operated in periphery and 9.09% in the tertiary care centre. Clinical presentations were intestinal obstruction (27.27%), intraabdominal abscess (13.18%), Discharging sinus (18.18%), mass abdomen (18.18%),entero cutaneous fistula (9.09%), peritonitis (9.09%). Exploratory laparotomy was done in 90.91%, to remove the foreign body and in 1 case passed per rectum. Conclusions: Retained foreign bodies presented as intestinal obstruction, abscess, sinus fistula mass, or peritonitis. It is avoidable iatrogenic surgical complication, mostly found in operations done in emergency and at peripheral hospitals. Exploratory laparotomy remains the mainstay of treatment to remove the intra-abdominal foreign body. Surgeon should be vigilant to avoid mishap by check on counting, tucking sponge, blackboard counting, examining abdomen, screening in suspicious case and claim for radio-opaque sponges.Referral system needs improvements for in time adequate treatment.

Intra-abdominal needle: Medical malpractice?

This case relates to an intra-abdominal foreign body which was detected in a patient. The patient claimed that this was a needle which had been negligently left in his abdomen by a surgical team following an appendectomy which had been performed 13 years previously (in 1994). A radiograph was taken in 2007 and compared against the pre-operative radiograph which had been taken in 1994. This showed that the foreign body had been in the patient's body prior to the appendectomy being performed. The foreign body was extracted from the patient's liver through laparoscopic surgery in 2007. Examination of the fragments revealed that the foreign body was a sewing needle. Medical literature suggests that the needle may have accidentally been ingested by the patient. This is a rare case of a migrated swallowed foreign body (there are only 46 similar cases reported worldwide). It is of interest that the patient's immediate reaction was to assume that this was a case of medical malpractice. This report discusses issues relating to this case that were raised during the criminal proceedings relating to the medical negligence claim.

Textiloma: en el diagnóstico diferencial de masas abdominales

We present a case of a pelvic mass of probable gynecological origin, whose principal suspected diagnosis was uterine myoma. Intraoperative findings excluded this diagnosis but failed to confirm other possibilities. The definitive diagnosis was delayed until the pathological report described a mass caused by a textile foreign body retained since an appendicectomy performed 18 years previously. The present report illustrates the discrepancy between the initial and definitive diagnosis, as well as the need to include an intraabdominal foreign body in the differential diagnosis of this type of mass in previously operated patients.

Foxing A Retained Intraabdominal Foreign Body After Surgery: A Nightmare For The Surgeon

Mere suspicion of a retained intraabdominal foreign body after surgery upsets the patient and the surgeon particularly in this consumer act era. We report a case history of a 41⁄2-year-old male child in whom clinical and radiological parameters lead to a high index of suspicion for a retained foreign body in the right hypochondrium following surgery for liver injury. But on reexploration, it was found to be a collection of pus, air and necrotic liver tissue between superior surface of the right lobe of the liver and right hemidiaphragm which was mimicking a retained foreign body.

Laparoscopic removal of intra-abdominal foreign body - Report of two successful cases

Laparoscopic removal of intra-abdominal foreign body - Report of two successful cases

Efficacy of Laparoscopic Surgery Combined with Intraoperative Fluoroscopy in Children

A 9-month-old girl weighing 6.2 kg with a chief sign of vomiting underwent laparoscopic gastropexy for gastric volvulus. Intraoperative fluoroscopy revealed the shape of the whole stomach and demonstrated that the most suitable site for gastropexy was between the anterior abdominal wall and the stomach. A 3-year-old boy weighing 15 kg had an asymptomatic intra-abdominal foreign body for 6 months. Abdominal radiography and CT showed a radiopaque foreign body in what seemed like a Meckel's diverticulum or the appendix. Laparoscopic observation combined with intraoperative fluoroscopy illustrated an intra-appendiceal foreign body, the tip of a metal toy. Its complete removal by laparoscopic appendectomy confirmed the accuracy of the diagnosis. Intraoperative fluorescopy during laparoscopic surgery is a very useful tool for correct diagnosis and treatment.

A CASE OF INTRAABDOMINAL INFLAMMATORY TUMOR CAUSED BY PERFORATION OF THE TRANSVERSE COLON DUETO A FISH BONE WHICH WAS PREOPERATIVELY DIAGNOSED

We sucessfully diagnosed a tumor of the abdominal wall of unknown origin existing over 10 years as intraabdominal inflammatory tumor caused by perforation of the transverse colon due to a fish bone before surgery. This paper describes the case with some pathological consideration and a review of the literature. A 74-year-old man was seen at the hospital because of abdominal pain, when a tumor with tenderness was palpated in the left upper portion of the navel. On blood chemical study, increases in the white blood cell count of 14, 300mm3 and CRP of 17mg/dl were noted. Abdominal CT and ultrasonography revealed a tumor shadow about 5cm in diameter with a linear high density center which was the same location as tenderness was felt. Barium enema study revealed a poorly extending portion in the middle of the transverse colon. Colonoscopy disclosed swelling of folds in mucosa of the transverse colon and redness just beneath the tumor. From these findings and a fact that the patient had a preference for fish, he was operated on with a diagnosis of intraabdominal inflammatory tumor caused by perforation of the transverse colon due to a fish bone. It was found out that a tumor was formed in the greater omentum and adhered to the transverse colon, jejunum and abdominal wall. A fish bone about 2.5cm in length was confirmed in the tumor. It is thought that an intraabdominal foreign body should be entertained as a probable diagnosis when we encounter intraabdominal tumors of unknown cause.