Complication of percutaneous endoscopic gastrostomy

Epidemiology and Surgical Management of Foreign Bodies in the Liver in the Pediatric Population: A Systematic Review of the Literature

“…The FBs retained were: sewing needle (9) [ 2 , 14 , 15 , 16 , 17 , 18 , 19 , 20 ], medical device (3) [ 4 , 5 , 21 ], gun pellet (2) [ 22 , 23 ], and pin (2) [ 24 , 25 ] The medical devices consisted in the distal part of a ventricular-peritoneal shunt [ 4 ], a gastrostomy bumper that was incorrectly inserted through the abdominal wall via the anterior surface of the left liver lobe [ 5 ] and a Kirshner wire that migrated to the liver from the hip [ 21 ].…”

“…The route of access to the liver parenchyma was detailed in seven cases: three patients ingested the FB [ 15 , 24 , 26 ], in four cases a direct penetration was reported (two gunshots [ 22 , 23 ], one ventricular-peritoneal shunt [ 4 ] and one gastrostomy bumper [ 5 ]), while in nine cases the route was either uncertain or not described [ 2 , 14 , 16 , 17 , 18 , 19 , 20 , 21 , 25 ].…”

“…More specific symptoms such as gastrostomy malfunction and neurological impairment were detected in patients with a retained medical device (gastrostomy malfunction and ventricular-peritoneal shunt malfunction, respectively) [ 4 , 5 ].…”

“…A CT-scan was performed in 43.7% of cases (seven out of 16) [ 2 , 4 , 16 , 17 , 18 , 19 , 20 ] as preoperative imaging. Finally, two patients underwent gastroscopy [ 5 , 15 ] while for one patient no preoperative data are available [ 22 ].…”

“…Multiple objects can be retrieved from the liver, such as sewing needles, hair pins or military equipment such as pellets or gun shots. In addition, some FBs may result from medical actions: insertion of a FB due to inaccurate surgical procedures or migration of medical devices [ 3 , 4 , 5 ].…”