Saif Al-Mudares1*, Ahmed Elaffandi2, Walid Elmoghazy2, Hatem Khalaf2 and Ameet Patel3
1Department of General Surgery, Hamad General Hospital, Doha, Qatar
2Department of Hepatobiliary Surgery, Hamad General Hospital, Doha, Qatar
3Department of Hepatobiliary Surgery, King’s College Hospital, London, UK
Introduction: Foreign Body (FB) ingestion is a common emergency presentation, and mostly courses through the Gastrointestinal (GI) tract uneventfully. It is rare to perforate the gut and very rare to lodge into the parenchyma of a solid organ, like liver or pancreas. Encountering a sharp object penetrating through the pancreas is very rare and terrific, with the paucity of existing evidence in the management of a similar situation, warrants a higher level of attention.
Case Report: Here we are presenting a very seldom case of ingested sewing needle, in a middle-age woman, piercing through the pancreas reaching up to the aorta, which was successfully retrieved laparoscopically. The patient presented to the emergency department with two weeks history of severe epigastric pain, without vomiting, hematemesis or melena. The patient reported that she had ingested accidentally a sewing needle 6 weeks ago, without any immediate complications. Urgent upper gastrointestinal endoscopy was done, but it failed to identify the sharp object. Appreciating the high risk of complications and the critical position of the needle, the patient underwent successful laparoscopic removal of the needle. A review of literature was made on the penetrating sharp objects to pancreas; including the very few reported cases which managed to retrieve them laparoscopically. Conclusion: The sharp object in the pancreas carries a high risk of fatal complication and should be taken seriously. When considering a surgical option for extraction, minimally invasive surgery, in
the presence of experienced hands is a valid choice.
Foreign body; Sewing needle; Pancreas; Laparoscopic
Al-Mudares S, Elaffandi A, Elmoghazy W, Khalaf H, Patel A. Successful Laparoscopic Retrieval of Ingested Sewing Needle in the Pancreas: A Case Report and Review of Literature. Ann Surg Case Rep. 2020; 3(4): 1039..