Laparoscopic extraction of an intrahepatic foreign body after transduodenal migration in a child.
We report on a 3-year-old boy who, after ingestion of turpentine, had an x-ray and was incidentally diagnosed with an intrahepatic needle. He was asymptomatic with no history of needle ingestion. Imaging (ultrasound and computed tomographic scans) showed a needle in segment 1, close to the inferior vena cava, with a proximal end in contact with the superior angle of the duodenum. Because of the localization of the needle and subsequent risks of complications, removal was proposed. Laparoscopy showed dense adhesions between liver and duodenum, confirming the migration route. Laparoscopic extraction of an entire sewing needle was performed. Postoperative course was uneventful; the child was discharged home after 2 days and is alive and well 19 months after surgery. Laparoscopy may be useful in children for extraction of intrahepatic foreign bodies, after transduodenal migration.
Dominguez
Stéphane
S
Paediatric Surgery Unit, University Children's Hospital of Geneva, 1211 Geneva, Switzerland.
Wildhaber
Barbara E
BE
Spadola
Luca
L
Mehrak
Anooshiravani-Dumont
AD
Chardot
Christophe
C
D002675:Child, Preschool; D004386:Duodenum / Q000000981:diagnostic imaging; D005547:Foreign Bodies / Q000000981:diagnostic imaging / Q000601:surgery*; D005548:Foreign-Body Migration / Q000000981:diagnostic imaging; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008099:Liver / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D009339:Needles; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014463:Ultrasonography