ABSTRACT
INTRODUCTION AND IMPORTANCE: Foreign body ingestion is most common in children, as well as adults with neurodevelopmental and psychiatric problems. The most commonly swallowed foreign bodies in adults include fish bones, chicken bones, toothpicks, and dentures. Sharp and elongated ones are the most typical causes of gastrointestinal perforation among the aforementioned. In about 1% of cases, foreign bodies are known to remain lodged within the bowel and cause luminal erosion and perforation. CASE PRESENTATION: A 23-year-old male construction laborer presented to the Emergency Surgical Unit of Debre Markos Hospital 7 h after he accidentally swallowed a nail while at work. He didn't have abdominal pain, vomiting, or rectal bleeding. On exams his vital signs were stable. His chest and abdominal exams as well as the digital rectal examination were unremarkable. He was evaluated with a plain erect abdominal x-ray based on his complaint, which revealed a long nail lying longitudinally in the right lower quadrant of the abdomen. Twenty-nine hours after swallowing the iron nail, he passed it through his rectum spontaneously. CONCLUSION: Plain radiography should be performed to locate and follow-up on radiopaque foreign entities before sophisticated imaging and invasive procedures. When treating people who have accidentally ingested a sharp foreign body, clinicians should find a balance between prompt action and careful follow-up.
ABSTRACT
INTRODUCTION: Biliary cystadenomas (BCAs) are rare benign tumors with malignant potential. They are most commonly found in middle-aged women and are quite infrequently reported in children. Even with advanced imaging, diagnosing and distinguishing BCA from other cystic liver lesions remain challenging. CASE PRESENTATION: A 5-year-old boy was brought in by his parents to our hospital with abdominal swelling that had been persistent for a year, along with loss of appetite and weight loss. On examination, the abdomen was distended and dull on percussion. We considered mesenchymal hamartoma of the liver (MHL) as the top differential after an abdominal CT scan with contrast showed a multi-loculated cystic tumour. For both definitive diagnosis and therapy, the patient underwent exploratory laparotomy with excision of the cystic mass. Surprisingly, histopathology examination of the resected specimen revealed biliary mucinous cystadenoma (BCA). CONCLUSION: Since conservative methods are associated with high recurrence rates, biliary mucinous cystic neoplasms require a high index of suspicion and should be handled with total surgical resection. In the post-operative phase, periodic surveillance imaging is recommended due to the risk of recurrence and malignant transformation.
