A rare cause of right iliac fossa lump: contained fish bone perforation of caecum

Ingested foreign bodies usually pass uneventfully through the gastrointestinal tract but few of them can cause symptoms. They can get stuck at acute angulations or narrow part of intestine and can perforate leading to localized to generalized peritonitis, collection or abscess formation. We describe a case of 59 year old gentleman who presented with pain in right iliac fossa with fever and a hard, tender lump. Initial investigation revealed a mass in right iliac fossa adherent to anterior abdominal was in right iliac fossa region with a foreign body inside. Patient was managed with exploratory laparotomy, removal of a fish bone from cacecum and limited right hemicolectomy. Fishbone perforation of caecum is a rare entity. Careful corroboration between patient’s presentation and radiological findings with a high index of suspicion is needed for pre-operative diagnosis.

Endoscopic Removal of a Spoon from the Stomach Using Guidewire / 대한소화기내시경학회지

Foreign body ingestion is a relatively uncommon, but potentially serious condition. Most of gastrointestinal foreign bodies pass spontaneously. But, large objectives are usually lodged in the stomach and cause perforation, bleeding, and obstruction. Therefore, prompt retrieval of lodged foreign bodies are necessary before complications develop. Particularly, in the case of long metallic spoon, there have been no cases of spontaneous passage reported. Therefore, prompt retrieval of a metallic spoon are necessary. A 28-year-old woman with schizophrenia who ingested a long spoon for suicidal attempt was referred to our hospital. Simple abdomen showed a 18 cm sized long, metallic spoon with saw-toothed end placed in the stomach. We removed a spoon by an endoscopic technique and an extraction maneuver using a guidewire and a Magill forceps.

Endoscopic Removal of Gastrointestinal Foreign Bodies in 3 Newborn Infants Immediately after Birth / 대한소화기내시경학회지

Since the introduction of flexible fiberoptic endoscope in clinical medicine from the early 1970s, the size of the caliber has become gradually so smaller and more functional as to be available in children and even in newborn infants. And the indications of gastrointestinal endoscopy have been extended not only to the diagnosis and evaluation of gastrointestinal diseases, but also to the effective management. Foreign body removal is one of the most important indications of therapeutic endoscopy in children. We have successfully removed foreign bodies in 3 newborn infants, using flexible endascope (0; 7.9 mm) without general anesthesia. They were one Nelaton catheter and two DeLee suction catheters which had been incidentaly broken during neonatal routine care in a delivery room. In the case of DeLee suction catheter ingestion, the end of the broken plastic bulb was snared and withdrawn carefully not to injure the esophageal mucosa by its sharp edge. All of the newborn infants got well thereafter and were discharged without any complications. We could avoid the general anesthesia and laparotomy by using flexible endoscope, and these 3 therapeutic endoscopic cases of newborn infants are the youngest patients reported so far. We hereby emphasize that foreign body can be removed easily and safely with routine gastrointestinal endoscope even in newborn infants.