GASTROINTESTINAL COMPLICATIONS OF ACCIDENTAL INGESTION OF FOREIGN OBJECTS.

Ingestion of foreign objects is common and most of the time, they pass without major problems. However sometimes they could cause significant morbidity or even mortality. Most of the time they cause pain in the pharyngeal or oesophageal area. In these instants, diagnosing the problem is straightforward, limiting the use of radiographic diagnosis. However the intraperitoneal complications include stomach or bowel perforation, obstruction, abscedation, septicemia or even hemorrhage or thrombosis of the abdominal veins. Because of the considerable risks, accompanied by the accidental ingestion of a metallic object, the preferred technique for screening is still Computed Tomography. However not all of these objects are radio-opaque and therefore could not always be diagnosed radiographically. In this article we will describe several cases of complications, due to the accidental ingestion of foreign objects. Also we will describe certain patient related risk factors significantly increasing, not only the amount, but also the severity of those complications. Diverticulosis seems the most common risk factor amongst the patients described and so it could be one of the more common triggers causing (recidivating) diverticulitis attacks. But because not all of the ingested foreign objects are radiopaque or still in the gastrointestinal tract, such a theory is difficult to prove.

Granular cell tumor in the breast mimicking breast carcinoma.

Granular cell tumor is also known as a granular cell myoblastoma, Abrikossoff's tumor, granular cell nerve sheath tumor or granular cell scwhannoma. It is a rare soft-tissue mass that can develop in any soft tissue. Most commonly it appears in the tongue (40%), the oral cavity or in the subcutaneous tissue. In rare occasions it is reported as a breast mass, mimicking a carcinoma. Not only clinically, but also on mammography, ultrasonography and macroscopically. Diagnosis can only be made on histology, emphasizing once again the importance of a thorough pre-operative multi-disciplinary assessment. We describe a case in which a woman presents herself with a palpable nodule in the breast in which clinical investigation, mammography and especially sonography indicated the presence of a malignancy. Only after we conducted a core biopsy for pre-operative histological investigation, we could make the diagnosis of a granular cell tumor, preventing an unnecessary mastectomy. The patient refused however local excision and was followed up with mammography and sonography.