Metallic sewing needle ingestion presenting as acute abdomen

Abstract

We reported an unusual case of a 26-year-old man presenting to surgical emergency as generalized peritonitis following an ingestion of multiple metallic sewing needles. The X-ray of his abdomen showed pneumoperitoneum and multiple metallic foreign bodies in the abdominal cavity. An ultrasonogram of his abdomen showed multiple metallic foreign bodies in the abdominal cavity and urinary bladder. Emergency exploratory laparotomy was performed. On laparotomy, gastric and duodenal perforation was found through which metallic sewing needles were protruding out. A peritoneal lavage was done, and all the sewing needles were extracted from the perforation site, paracolic gutter, liver parenchyma, and urinary bladder. The primary repair of the perforation with omental patching was done with the drainage of subhepatic space and pelvic cavity. These multiple ingested sewing needles led to the perforation of the stomach and the duodenum, which resulted in perforation peritonitis.

A Swallowed Metal Nail Entrapped in the Right Psoas Muscle

“…[1,2] In mentally retarded patients, cases similar to the present, of foreign body ingestion resulting from hallucination, have been reported. [1] The present patient had psychiatric consultation in the early postoperative stage, upon the assumption that her mental retardation may have led to repeated foreign body ingestion.…”

“…[2,5] Following foreign body retrieval, treatment of mental disorder, if applicable, in order to prevent repeated ingestion, is of prime importance. [1] Presently described were the clinical properties of a mentally retarded woman with repeated foreign body ingestion, who ingested a 12-cm nail, which became entrapped in the right psoas muscle after perforating the third portion of the duodenum. Also described were reported diagnostic and treatment approaches.…”

“…Cases of intentional foreign body ingestion have also been reported. [1,2] Commonly ingested objects include coins, needles, pins, jewelry, toy parts, teaspoons, nails, batteries, dentures, fish and chicken bones, and items used to handle food, such as lollipop sticks. These objects may be made of plastic, metal, or toxic material.…”

“…These objects may be made of plastic, metal, or toxic material. [1][2][3][4][5][6][7][8][9] Most ingested foreign bodies are naturally discharged from the body within 4-6 days. However, serious complications in the gastrointestinal system such as obstruction or perforation may occur, requiring surgical intervention.…”

“…These complications may also be associated with clinical presentations such as nausea, vomiting, and acute abdomen, depending on the location and severity of the obstruction and perforation. [1,[5][6][7][8][9] Endoscopic approach is the method of choice in the treatment of ingested foreign bodies. However, laparoscopy and laparotomy may also be required in cases of perforation or obstruction.…”