• endoscopy
• foreign body ingestion
• toothpick
• wooden objects

• Ingestion of dentures
• Ingestion of foreign bodies

• X‐ray computed
• drug packaging
• eating
• endoscopy
• foreign bodies
• gastrointestinal
• tomography

• duodenal perforation
• emergency surgery
• non operative management
• swallowed foreign body
• upper gastrointestinal endoscopy (ogd)

• bowel perforation
• computed tomography
• foreign-body
• multiplanar reconstruction
• volume rendering technique

• consumer product safety
• foreign body ingestion
• ingestion
• national electronic injury surveillance system
• pediatric ingestion

• Humans
• Foreign Bodies/epidemiology
• Retrospective Studies
• Child
• Child, Preschool
• Esophagus
• United States/epidemiology
• Infant
• Male
• Female
• Incidence
• Adolescent
• Play and Playthings
• Emergency Service, Hospital/statistics & numerical data
• Emergency Service, Hospital/trends
• Electric Power Supplies/adverse effects
• Eating

• accidental ingestion
• endoscopy
• gastroenterology
• gastrointestinal foreign body
• toothbrush

• duodenum
• endoscopy
• foreign body
• renal pelvis

• colonic diverticulitis
• endoscopic removal
• foreign body ingestion complications
• small bowel perforation
• toothpick

• Internal fistula
• acute appendicitis
• colon anastomosis
• magnet bead

• Innovation capacity Building project, enterprise key laboratory cultivation of Yangzhou
• Social development project of Yangzhou

• case report
• foreign body
• perforation peritonitis

• Micro-Electrical-Mechanical Systems
• Drug Delivery Systems
• Microfluidics
• Lab-On-A-Chip Devices
• Nanotechnology

• 63 coins from the stomach
• dr. sampurnanand medical college
• endoscopic removal
• jodhpur
• july 2022

• Coronavirus
• face mask
• foreign body

• deliberate
• foreign
• ingestion
• object
• recurrent

Foreign body ingestion is a common case in daily medical care, and it usually passes through the entire gastrointestinal tract naturally and is excreted in the feces. However, long and sharp foreign bodies may be difficult to pass naturally due to their shape. Here, we present a rare case of a duodenal foreign body, a toothbrush, that required laparoscopic surgical removal after a failed endoscopic attempt.

A 51-year-old male with intellectual disability presented to our hospital due to fever. Initially, he was diagnosed with aspiration pneumonia by chest X-ray and blood examination. However, abdominal X-ray examination suggested a foreign body, and a computed tomography scan revealed a toothbrush in the duodenum. Therefore, upper gastrointestinal endoscopy was immediately attempted to remove it, but it could not be safely removed because the handle part of the toothbrush seemed deeply embedded in the duodenal mucosa. Therefore, this case was diagnosed as duodenal incarceration of the toothbrush, and it was removed by laparoscopic surgery. The operation was performed safely, and the patient’s postoperative course was good without any complications. The extracted toothbrush was 15 cm in length.

We experienced a rare case of a duodenal foreign body, which was a toothbrush. The duodenal foreign body was safely removed by laparoscopic surgery for the first time.

• Gastrointestinal surgery
• General surgery

• Male
• Humans
• Bezoars/diagnosis
• Bezoars/diagnostic imaging
• Plastics
• Intestinal Obstruction/diagnostic imaging
• Intestinal Obstruction/etiology
• Intestinal Obstruction/surgery
• Diatrizoate Meglumine
• Affect

• Anthropogenic debris
• Catfish
• Dolphin
• Entanglement
• Gharial
• Plastic ingestion

• Animals
• Animals, Wild
• Birds
• Dolphins
• Ecosystem
• Plastics
• Rivers

• Fishbone
• Perianal abscess
• Surgery

• bioavailability
• gastrointestinal tract
• macromolecules
• oral drug delivery
• physical oral device

• Foreign body
• gastrotomy
• ingestion
• percutaneous
• stomach perforation

• Case report
• Colonoscopy
• Foreign body

Adults with foreign body ingestion are mainly secondary to psychiatric disorders, alcoholic intoxication, and secondary gains. Conservative management without any intervention is successful in 80% of the ingested foreign bodies. Risk factors for complication include sharp objects, objects larger than 6 mm, recurrent ingestion, and previous gastrointestinal tract surgeries. Sharp objects specifically account for 35% perforation rates and impactions, most commonly at the ileocecal valve. There is limited evidence on the role of colonoscopy after the distal migration of foreign bodies into the ileum and colon.

In our case report, we present a case of a 53-year-old-male with a history of recurrent foreign body ingestion secondary to a multitude of psychiatric disorders. It describes multiple foreign body ingestions, leading to failure of a screw at the ileocecal valve at day 5 of ingestion, despite conservative management with serial bowel preparations and abdominal radiographs. There is limited evidence on the management of foreign bodies after distal migration to the ligament of Trietz. Existing literature and guidelines suggest surgically managing the sharp foreign bodies after the failure of conservative management for three to five days.

In the case report, we have attempted to emphasize the noninvasive, colonoscopic approach as initial management in removing impacted foreign bodies.

This abstract has been presented and accepted at the American college of gastroenterology meeting held from October 22, 2021, to October 27, 2021, in Las Vegas as a poster.

Patient: Male, 23-year-old

Final Diagnosis: Foreign body ingestion

Symptoms: Abdominal pain • nausea

Medication: —

Clinical Procedure: —

Specialty: Gastroenterology and Hepatology • General and Internal Medicine • Psychiatry • Toxicology

A child swallowing a long metallic spoon is an extremely rare phenomenon. Foreign bodies longer than 6 cm are unlikely to pass through the gastrointestinal tract spontaneously and require endoscopic or surgical removal in order to avoid associated complications, such as visceral perforations.

A 13-year-old child presented with accidental swallowing of a metallic spoon 10 days prior to hospital admission. He had history of loss of appetite, epigastric and left upper quadrant abdominal pain and started to have high grade intermittent fever 11 days after swallowing the spoon. A plain abdominal radiograph revealed a metallic spoon in the mid-abdomen. An exploratory laparotomy revealed an 11 cm long metallic spoon impacted at the duodeno-jejunal junction with walled off perforation and erosion of the mesentery of the colon. The metallic spoon was removed and the perforated site was repaired. The surgery was smooth and the patient recovered fully and was discharged seven days post-operation.

A swallowed long metallic spoon is unlikely to pass spontaneously and should be removed as soon as possible in order to avoid associated complications like impaction, perforation and subsequent peritonitis.

• case report
• doudeno-jejunal junction
• foreign body
• spoon

• Epithelial layer
• Injection
• Iontophoresis
• Jetting
• Microneedles
• Ultrasound

• Animals
• Drug Delivery Systems
• Gastrointestinal Tract
• Humans
• Iontophoresis
• Mucous Membrane
• Ultrasonic Waves

• Capsule endoscope
• Drug delivery capsule
• Gastrointestinal diagnosis
• Gastrointestinal therapy
• Ingestible electronics
• Smart pill

Ingestion of foreign bodies (FBs) is common and rarely has consequences for the patient, but sometimes it can originate gastrointestinal perforation and lead to devastating consequences if unrecognized. Therefore, whenever present, bowel perforation demands immediate surgical treatment.

An 89-year-old woman with an incarcerated incisional hernia, whose imaging study was consistent with intestinal occlusion and perforation within the hernia sac was treated at our hospital. A segmental enterectomy and direct correction of the hernial defect were performed. A perforation in the mesenteric border due to a FB, which seemed to be a toothpick, was identified in the surgical specimen. Nine months after surgery, the patient was without complaints, with adequate healing, and without evidence of hernial recurrence.

To the best of our knowledge, this is the first case of intestinal perforation on an incarcerated incisional hernia, due to an ingested FB, reported in the literature.

Fish bone is one of the most common foreign body ingestions encountered in the emergency department. Fish bone perforations occur most commonly in segments with acute angulation like the ileocecal region and rectosigmoid junction and can present acutely with obstruction and free air or with chronic complications like abscess and sepsis. Radiologists should be familiar with the high-risk clinical scenarios, the CT appearance of radiopaque fishbones, and the spectrum of imaging findings related to gastrointestinal (GI) tract so as to direct management and timely referral to GI endoscopists and surgeons.

• Fish foreign body
• computed tomography
• gastrointestinal tract
• injury

• CT
• emergencies
• fluoroscopy
• gastric

• direction of penetration
• fish bone
• gastric penetration

• Child
• Child, Preschool
• Eating
• Foreign Bodies/diagnostic imaging
• Foreign Bodies/epidemiology
• Hospitalization
• Humans
• Inpatients
• Length of Stay
• Male
• Retrospective Studies

Foreign body ingestion is a frequent condition, with the majority of foreign bodies (FBs) tending to spontaneously proceed along the gastrointestinal tract without any major complications. A wide range of procedures are available to remove FBs; however, a real challenge exists in managing sharp, rigid, and long foreign objects, which are related to higher rates of complications. A 34-year-old man who intentionally swallowed a metallic wire of 20 cm length, presented to our ED with abdominal pain 2 weeks after the ingestion. The FB had migrated to the stomach and duodenum. Complications included perforation of the duodenum and ascending colon and a retroperitoneal abscess. FB removal was done via laparotomy, followed by the repair of perforations and damaged tissues. This case highlights the complications of a FB presence in the gastrointestinal tract for 14 days and emphasizes the importance of urgent and appropriate management of such conditions.

• Foreign body ingestion
• abscess
• metallic wire
• perforation
• surgery

A 68-year-old man presented to the hospital with severe right upper abdominal pain, fevers, nausea and lethargy. He deteriorated into septic shock and was found to have a hepatic abscess on computer tomography imaging. After multiple investigations and continual deterioration, he underwent an exploratory laparoscopy which revealed a chicken bone within the liver parenchyma resulting in a large hepatic abscess. The patient required a second laparoscopic washout and prolonged antibiotics, subsequently recovering well. This rare case highlights the difficulty in diagnosing hepatic abscesses caused by gastrointestinal foreign bodies, and successful management with laparoscopic surgery.

• gastro-intestinal perforation
• general surgery
• hepatic abscess
• ingested foreign body
• laparoscopic surgery

•

The knowledge about this type of hernia has especially gained importance in the context of laparoscopic surgery as majority of the laparoscopic port site hernias are characteristically Richter’s type in configuration.

Richter’s hernia is a clinically deceiving entity as is particularly associated with high morbidity and mortality which can be can be abated by timely diagnosis and surgery. Direct inguinal hernias having a wide neck have lesser chances of incarceration and strangulation when compared to indirect inguinal hernias. The knowledge about this type of hernia is especially important in the context of laparoscopy as majority of the laparoscopic port site hernias are characteristically Richter’s type in configuration. The objective of this report is to highlight the unusual presentation of the case and sine quo non of prompt diagnosis and timely surgery remains the cornerstone of management.

We report a case of Richter’s hernia incarcerated due to an impacted foreign body (match stick) through a direct inguinal hernia. Patient presented with a painful, non-expansile, tender swelling in left groin. Patient was diagnosed with a complicated inguinal hernia and underwent exploration with resection of involved bowel segment and primary repair of hernia.

Richter’s hernia is a rare abdominal wall hernia specifically known for its unusual and delayed presentation leading to high rates of morbidity and mortality. Direct inguinal hernias are less prone to complications like obstruction, strangulation and incarceration owing to presence of a wide neck. Clinical suspicion, prompt radiological diagnosis and timely surgery can lead to an uneventful recovery.

Surgery is the only treatment, but timely surgery remains the golden opportunity. Critical in repair is the evaluation of intestinal viability.

• Case report
• Foreign body
• Incarcerated hernia
• Richter’s hernia
• Unusual hernia

• case report
• foreign body
• laparotomy
• metal bezoar

Intestinal perforation following the ingestion of fishbone is unusual and rarely diagnosed preoperatively, as clinical and radiological findings are non-specific. We report a case of a female patient post Roux-en-Y gastric bypass (RYGBP) for obesity, who presented with severe abdominal pain and guarding in left iliac fossa. Computed tomography (CT) suggested internal herniation with compromised vascular supply to the bowel. Exploratory laparotomy identified a perforation site in the blind loop of the RYGBP due to a protruding fishbone. After extraction, primary suture repair was performed. In retrospect, the fishbone was identified on CT but misinterpreted as suture line at the enteroenterostomy site. This case emphasizes that although rare, the ingestion of fishbone can lead to severe complications and should therefore be included in the differential for an acute abdomen. On CT, it should be noted that fishbone may simulate suture line within the bowel if the patient has history of previous surgery.