Laparoscopic removal of an ingested pin migrating into the liver.

Most ingested foreign bodies pass through the gastrointestinal tract without giving rise to complications. The possibility of penetration of the intestinal tract, by sharp, pointed objects, however, necessitates careful and continued observation. If such objects become lodged in a narrow segment of the gastrointestinal tract, perforation may occur. The resulting morbidity depends on the further route of the penetrating object and whether septic sequelae ensue. Although foreign bodies may migrate to almost any intraabdominal organ, perforation of the duodenum and migration into the liver are extremely rare. A case of a woman who unknowingly ingested a pin that perforated the duodenum causing only few acute symptoms is presented. Biliary tract pathology was suspected, but ultrasound examination ruled it out. Computed tomography of the abdomen showed a pin thrust into the liver, with the head of the pin in the wall of the duodenum. Traditional surgical treatment requires laparotomy for foreign body removal. In the reported case, the pin was removed laparoscopically. The postoperative course was uneventful, and the patient left the hospital on day 2 after the procedure. With laparoscopic approach for removal of penetrating intestinal foreign bodies, laparotomy and its attending complications are avoided. This approach is less invasive, has a beneficial impact on postoperative pain, produces a better cosmetic result, and offers a faster return to normal activities. Hospital stay and costs also are reduced.