Laparoscopic Removal of Multiple Self-embedded Needles in the Peritoneal Cavity：A Case Study

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  • Takano Yojiro
    Digestive Disease Center, Showa University Northern Yokohama Hospital
  • Nakahara Kenta
    Digestive Disease Center, Showa University Northern Yokohama Hospital
  • Kakisako Kensuke
    Digestive Disease Center, Showa University Northern Yokohama Hospital
  • Seki Junichi
    Digestive Disease Center, Showa University Northern Yokohama Hospital
  • Oae Sonoko
    Digestive Disease Center, Showa University Northern Yokohama Hospital
  • Shimada Shoji
    Digestive Disease Center, Showa University Northern Yokohama Hospital
  • Takehara Yusuke
    Digestive Disease Center, Showa University Northern Yokohama Hospital
  • Mukai Shunpei
    Digestive Disease Center, Showa University Northern Yokohama Hospital
  • Enami Yuta
    Digestive Disease Center, Showa University Northern Yokohama Hospital
  • Sawada Naruhiko
    Digestive Disease Center, Showa University Northern Yokohama Hospital
  • Ishida Fumio
    Digestive Disease Center, Showa University Northern Yokohama Hospital

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Other Title
  • 自傷行為により経皮的に侵入した複数の伏針を腹腔鏡下に摘出した1例
  • ジショウ コウイ ニ ヨリ ケイヒテキ ニ シンニュウ シタ フクスウ ノ フクシン オ フククウキョウ カ ニ テキシュツ シタ 1レイ

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Abstract

<p>The patient was a woman in her 20s who was undergoing treatment for schizophrenia and had a history of repeated self-harm during the treatment. She was admitted to our hospital with the chief complaint of persistent upper abdominal pain. A plain abdominal X-ray revealed the presence of 10 wire-like foreign bodies that appeared to be needles. Abdominal computed tomography further suggested that some of these needles may have punctured the liver and colon. We performed emergency laparoscopic surgery and identified 7 needles that were covered by the omentum in the peritoneal cavity. While some of the needles had either punctured the liver or were in contact with the colon, we determined that there was no need for hemostasis or repair of the colon. The needles found in the peritoneal cavity were carefully removed laparoscopically under X-ray fluoroscopic guidance. The extracted needles included 3 straightened-out paper clips and 7 sewing needles. We demonstrated that combined use of laparoscopy and X-ray fluoroscopy was effective in removing a relatively large number of foreign bodies (10 needles) in a safe and minimally invasive manner. Our findings also suggest that elective surgery may be considered if the needles were self-embedded through the skin, since the risk of organ damage in such cases is minimal.</p>

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