title: Combined endo-laparoscopic approach in a patient with a duodenal foreign body and bowel obstruction.
abstract: 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.
authors.affiliation: Digestive Endoscopy Unit, Ospedale Civile di Villa d'Agri, ASP Potenza, Via Provinciale, Marsicovetere, 85050, Villa d'Agri (Potenza), Italy, francescaromana.defilipp@tin.it.
authors.forename: Francesca Romana
authors.initials: FR
authors.lastname: de Filippo
authors.forename: Nicola
authors.initials: N
authors.lastname: Perrotta
authors.forename: Antonio
authors.initials: A
authors.lastname: Cappiello
authors.forename: Torquato
authors.initials: T
authors.lastname: Esposito
authors.forename: Domenico
authors.initials: D
authors.lastname: Loffredo
mesh_terms: D000368:Aged; D004380:Duodenal Obstruction / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D004384:Duodenoscopy / Q000379:methods*; D004386:Duodenum; D005547:Foreign Bodies / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D014057:Tomography, X-Ray Computed