Endoscopic resolution of gastric perforation with pancreas penetration by a fish bone

Martínez, Óscar Núñez; García, Cecilia Sanz; Enciso, Irene Pérez; Ortiz, Leticia Holguera; Alonso, José María Alberdi

doi:10.1016/j.gastre.2018.11.002

Cited by 3 publications

(2 citation statements)

References 5 publications

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“…It is estimated that around 1% of swallowed foreign bodies penetrate the gastric and duodenal wall, traveling within the abdominal cavity and potentially reaching the liver, pancreas, spleen or even further into the thoracic cavity. 28,33 Our literature review revealed 41 cases of intrapancreatic foreign bodies (Table 3), including 14 suture needles, [23][24][25][26][27][28][29][30][31] 4 metal wires, [32][33][34][35] 19 fish bones, 7,[36][37][38][39][40][41][42][43][44][45][46][47][49][50][51][52][53][54] 2 other pointed bones 55,56, and 2 toothpicks. 57,58 All these foreign bodies are believed to have migrated from the stomach or the duodenum.…”

Section: Hypothesis Of Earlier Ingestionmentioning

confidence: 99%

Foreign Glass Bodies in Pleura and Pancreas: Systematic Review for Entry Hypotheses and Treatment Options in an Unresolved Case

Ehrsam,

Meier Adamenko,

Schlumpf

et al. 2024

Surgical Laparoscopy, Endoscopy &Amp; Percutaneous Techniques

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Background: Foreign bodies within the pleura and pancreas are infrequent, and the approaches to their treatment still a subject of debate. There is limited knowledge particularly regarding glass foreign bodies. Methods: We present a case involving large glass splinters in the pleura and pancreas, with an unknown entry point. In addition, a systematic review was conducted to explore entry hypotheses and management options. Results: In addition to our case, our review uncovered eight incidents of intrapleural glass, and another eight cases of glass in other intrathoracic areas. The fragments entered the body through impalement (81%), migrated through the diaphragm after impalement (6%), or caused transesophageal perforation (19%) following ingestion. Eight instances of glass inside the abdominal cavity were documented, with seven resulting from impalement injuries and one from transintestinal migration. There were no recorded instances of glass being discovered within the pancreas. Among the 41 nonglass intrapancreatic foreign bodies found, sewing needles (34%) and fish bones (46%) were the most common; following ingestion, they had migrated through either a transgastric or transduodenal perforation. In all these cases, how the foreign bodies were introduced was often poorly recalled by the patient. Many nonglass foreign bodies tend to become encapsulated by fibrous tissue, rendering them inert, though this is less common with glass. Glass has been reported to migrate through various tissues and cavities, sometimes with a significant delay spanning even decades. There are cases of intrapleural migration of glass causing hemothorax, pneumothorax, and heart and major blood vessels injury. For intrapleural glass fragment management, thoracoscopy proved to be effective in 5 reported cases, in addition to our patient. Most intrapancreatic nonglass foreign bodies tend to trigger pancreatitis and abscess formation, necessitating management ranging from laparoscopic procedures to subtotal pancreatectomy. There have been only four documented cases of intrapancreatic needles that remained asymptomatic with conservative management. There is no direct guidance from the existing literature regarding management of intrapancreatic glass foreign bodies. Consequently, our patient is under observation with regular follow-ups and has remained asymptomatic for the past 2 years. Conclusions: Glass foreign bodies in the pleura are rare, and our report of an intrapancreatic glass fragment is the first of its kind. Impalement is the most likely method of introduction. As glass has significant migration and an ensuing complication potential, preventive removal of intrapleural loose glass should be considered. However, intrapancreatic glass fragment management remains uncertain.

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Section: Hypothesis Of Earlier Ingestionmentioning

confidence: 99%

Foreign Glass Bodies in Pleura and Pancreas: Systematic Review for Entry Hypotheses and Treatment Options in an Unresolved Case

Ehrsam,

Meier Adamenko,

Schlumpf

et al. 2024

Surgical Laparoscopy, Endoscopy &Amp; Percutaneous Techniques

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“…Surgical treatment by laparoscopy is considered a safe and effective procedure, with lower complication rates and hospital stay. The trend in foreign body management is towards minimally invasive treatment, with endoscopic management gradually gaining prominence (5).…”

Section: Clinical Casementioning

confidence: 99%

Acute necrotising pancreatitis secondary to a pancreatic foreign body

Moreno Barrueco,

Berdugo Hurtado,

López Peña

et al. 2023

Rev Esp Enferm Dig

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Gastric perforation by fish bone: Case report

Milano¹,

Monsalve²,

Pascarelli³

2019

GHOA

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Introduction: The ingestion of foreign bodies is usually accidental and asymptomatic, it is observed more frequently in patients with psychiatric diseases, children and older adults, being able to cause gastric perforation in 1% of cases. Clinical case: A 70-year-old male patient who comes to the emergency due to severe pain located in the epigastrium, with the presence of a palpable, painful mass with irregular edges. Discussion: the preoperative diagnosis of hollow viscera perforation by a foreign body must take into account the epidemiological history, directed interrogation, physical examination and paraclinical studies to allow its differentiation with other medical or surgical entities, allowing the appropriate preoperative and intraoperative management of the patient. Conclusion: In spite of the infrequent, the perforation of hollow viscera by foreign body should be a differential diagnosis to be considered by the general surgeon.

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Endoscopic resolution of gastric perforation with pancreas penetration by a fish bone

Cited by 3 publications

References 5 publications

Foreign Glass Bodies in Pleura and Pancreas: Systematic Review for Entry Hypotheses and Treatment Options in an Unresolved Case

Foreign Glass Bodies in Pleura and Pancreas: Systematic Review for Entry Hypotheses and Treatment Options in an Unresolved Case

Acute necrotising pancreatitis secondary to a pancreatic foreign body

Gastric perforation by fish bone: Case report

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