A Rare Complication of an Ingested Foreign Body: Gallbladder Perforation

Abstract

We present a 13-year-old child who admitted with a dull right upper quadrant pain that started 3 weeks before her referral. Several medications were given but they did not change the intensity and the frequency of the pain. Her physical examination was nonspecific except for slight right upper quadrant tenderness. The imaging studies revealed a sewing pin perforating the stomach and gallbladder. The patient was treated with a successful operation, and no postoperative complications were observed. To our knowledge, this is the first case of a sharp foreign body gallbladder perforation in a child.

Perforation of the Gallbladder Due to a Swallowed Sewing Needle: Case Report

“…For foreign bodies that have been ingested and are in the stomach and duodenum, general management is usually the conservative approach. There may be an indication for surgery in situations, as in our present case, if there is a history of foreign body ingestion and failure of its progression as well as the presence of acute abdomen (1,5). Traditional surgical treatment requires laparotomy for foreign body removal, but the laparoscopic approach for intestinal foreign bodies has also been reported (1,10).…”

“…A detailed history and wise planned serial imaging are crucial steps after foreign body ingestion. Ultrasonography methods may help diagnose the presence of a gallbladder perforation by displaying distention and fluid collection around the gallbladder as well as free fluid in the peritoneal cavity (5)(6)(7)(8). In our case, due to the lack of serial imaging, it resulted in a delayed diagnosis.…”

“…The perforation of the gallbladder by an ingested sewing needle is an extremely rare complication (7). Some etiological and predispos-ing factors causing gallbladder perforation include calculous and acalculous cholecystitis, blunt and sharp abdominal trauma, collagen tissue disorders, malignancy, corticosteroid therapy, impaired vascular supply to the gallbladder, diabetes mellitus, old age, and male gender (5,7,8). The mortality rate of gallbladder perforation is between 15% and 20% (6)(7)(8).…”

“…Fortunately, swallowed foreign bodies rarely perforate the organs and migrate into the abdominal cavity; however, if it happens, laparotomy is indicated (1,4). Although isolated perforations of hollow organs such as the stomach have been reported due to swallowed sewing needles, it is very uncommon for co-existent perforations of the stomach and gallbladder to occur (5,6). We attempted to present the case of a patient coming to the emergency room with abdominal pain and a one-month history of a swallowed sewing needle, leading to the perforation of both the stomach and the gallbladder that required cholecystectomy and gastrorrhaphy.…”