Foreign Body Ingestion in an Adolescent – A Case Report and Literature Review

Nguyen, James; Chou, Charles C.‐K.; Chen, Nelson; Yu, Aidan; Lee, Shelly

doi:10.21767/amj.2017.2917

Cited by 1 publication

(5 citation statements)

References 12 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, 23–31 4 metal wires, 32–35 19 fish bones, 7,36–47,49–54 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: Discussionmentioning

confidence: 98%

“…28 , 33 Our literature review revealed 41 cases of intrapancreatic foreign bodies (Table 3 ), including 14 suture needles, 23 – 31 4 metal wires, 32 – 35 19 fish bones, 7 , 36 – 47 , 49 – 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. Most cases became symptomatic within days or weeks, resulting from complications such as abscess formation, 32 , 38 – 41 , 51 , 54 – 58 hematoma, 53 pseudoaneurysm, and acute to chronic pancreatitis with high morbidity and mortality.…”

Section: Discussionmentioning

confidence: 99%

“…Most cases became symptomatic within days or weeks, resulting from complications such as abscess formation, 32 , 38 – 41 , 51 , 54 – 58 hematoma, 53 pseudoaneurysm, and acute to chronic pancreatitis with high morbidity and mortality. 23 , 39 , 41 , 47 , 57 However, in 4 cases involving ingested sewing needles lodged in the pancreas, 30 , 31 no clinical symptoms were noted and the patients were treated conservatively. In another case, a 6.4-cm needle became symptomatic after a latency period of 8 years.…”

Section: Discussionmentioning

confidence: 99%

“…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. Most cases became symptomatic within days or weeks, resulting from complications such as abscess formation, 32,[38][39][40][41]51,[54][55][56]…”

Section: Hypothesis Of Earlier Ingestionmentioning

confidence: 99%

“…57,58 All these foreign bodies are believed to have migrated from the stomach or the duodenum. Most cases became symptomatic within days or weeks, resulting from complications such as abscess formation, 32,[38][39][40][41]51,[54][55][56][57][58] hematoma, 53 pseudoaneurysm, and acute to chronic pancreatitis with high morbidity and mortality. 23,39,41,47,57 However, in 4 cases involving ingested sewing needles lodged in the pancreas, 30,31 no clinical symptoms were noted and the patients were treated conservatively.…”

Section: Hypothesis Of Earlier Ingestionmentioning

confidence: 99%

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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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