Laparoscopic assisted foreign body extraction from the small bowel: A case report

腹腔镜辅助下小肠异物取出术:病例报告

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Abstract

BACKGROUND AND AIM: Foreign body ingestion is a commonly seen accident in emergencies, only 1% of them will finally need surgery. Historically, exploratory laparotomy has been the mainstay of treatment for patients requiring surgery. However surgeons are more and more tempted to use laparoscopy in emergency setting.Through this case report we wanted to show in some selected cases the feasibility of laparoscopic assisted foreign body extraction from the small bowel leaving the patient with smaller scar, less morbidity and faster recovery. CASE PRESENTATION: A 30 year old male Inmate, ingested 40 days prior to his visit a bottom part of plastic bottle.Physical examination found an afebrile patient with a whole abdominal tenderness but no signs of peritonitis.The Abdominal Computed Tomography found a small bowel obstruction caused by a foreign body. No Radiological sign of perforation or peritonitis was found.First therapeutic strategy was to wait and see, for 24 h with no sign of improvement and the patient was taken to surgery. We opted for a laparoscopic approach y. The patient had bowel and gas movement the day after surgery. In the third day, the patient had developed a parietal abscess Treated medically. In the 10th day, after surgery the patient was discharged.Fourteenth month after the surgery, the patients is doing well with no late complication. CONCLUSION: Laparoscopic assisted foreign body extraction from the small bowel is a good therapeutic option however Large scale randomized controlled trials are needed before this can be used as a standard of care.

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