Trans-colonic foreign body penetration of the retro-hepatic vena cava. Report of a case and review of the literature

Abstract

Foreign body ingestion is common in mentally impaired adults. Fortunately, the vast majority of all swallowed objects pass through the gastrointestinal tract uneventfully. For patients in whom conservative treatment fails, early endoscopic intervention is required. Surgery is seldom indicated and reports of perforation or penetration of the GI tract are anecdotal. We present a case of a 32 years old mentally impaired patient with a trans-colonic penetration of a foreign body into the retro-hepatic vena cava.

Duodenal and inferior vena cava perforation due to a rosemary branch ingestion: a Case Report

“…[16] Gastrointestinal perforations due to foreign bodies occur along the GI tract due to acute bowel angles, the reduced caliber of the lumen and the transition from a a mobile tract of the bowel, like the ileum and sigmoid; to a fixed one such as cecum and rectum. [17] The analysis performed by Chung showed that the most common sites of perforation are the small bowel with 39.8% followed by duodenum (22%), colon (20.3%), rectum (10.6%) and sigmoid colon (5.5%) [7] [8]. Additionally, there are other less-represented areas of perforation such as the duodenojejunal flexure, the appendix, the colonic flexure, diverticula, and the anal sphincter.…”

Laparoscopic retrieval of a fishbone migrating from the stomach causing a liver abscess: Report of case and literature review

“…The authors reported previously of a trans-colonic FB penetration to the retrohepatic vena cava in a mentally impaired patient. [ 5 ]…”

Toothpick ingestion and migration into the liver through the colonic hepatic flexure: case presentation, management, and literature review

“…Patients will report a history of recurrent abdominal pain, fever of unknown origin, like our patient, nausea, obstipation, diarrhea etc. . The diagnostic work‐up usually consists of EGD, colonoscopy, computed tomography scan, and ultrasound, but failure to detect the toothpick was reported in 35% of the cases.…”

“…The patient's age, mental capabilities, clinical characteristics, and socioeconomic status should also raise questions. The surgeon should be prepared for life‐threatening situations such as major vascular involvement , as well as highly specialized and technically challenging procedures if the toothpick involves the hepatic hilum for instance .…”