Talk Descripción
Institución: Princess Alexandra Hospital - QLD, Australia
Hepatic foreign bodies are a rare sequela of gastrointestinal perforation following ingestion of sharp objects. Most ingested foreign bodies traverse the gastrointestinal tract without complication or are managed endoscopically when symptomatic. Hepatic migration is uncommon and may present diagnostic challenges to the general surgeon. A 64 year old woman presented with several days of abdominal pain following consumption of a barbeque-cooked meal. Biochemistry demonstrated an elevated white cell count and mild derangement of liver function tests. Computed tomography revealed a curvilinear hyperdensity within segment 4b of the liver, without surrounding inflammation. The patient was subsequently taken to theatre and underwent successful laparoscopic retrieval of the foreign body without complication. Her postoperative course was uneventful, and she recovered well. Hepatic foreign bodies are likely under-reported due to asymptomatic presentations, while symptomatic cases may present with abdominal pain, fever, jaundice, or abnormal liver function tests. Computed tomography in the portal venous phase is the diagnostic modality of choice, as oral contrast may obscure identification of foreign material. Accidental ingestion of wire-bristles most commonly results in upper aerodigestive tract injury, with intra-abdominal complications usually occurring at points of luminal narrowing such as the ileocecal junction. This case highlights the importance of maintaining clinical suspicion of ingested foreign body in patients with abdominal pain whilst demonstrating the ability to manage this issue with minimally invasive surgery when promptly diagnosed.
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Dr Hamish Mcdonald - , Dr Andrew Nathanson -
