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25 February 2011

Migration of a foreign body into the colon and its autonomous excretion

Andrzej ModrzejewskiBEF, Adam KiciakBEF, Marcin ŚledżDE, Katarzyna SygitDE, Katarzyna Borycka-KiciakBCE, Wilhelm GrzesiakAC, Wiesław TarnowskiAFG

DOI: 10.12659/MSM.881438

Med Sci Monit 2011; 17(3): CS34-38

Abstract

Background: The frequency of foreign body retention in the abdominal cavity ranges from 1 in 100 to 1 in 3000 surgeries performed. Worldwide literature describes only a few cases of the migration of misplaced surgical gauze into the colon.
Case Reports: The first case is a 60-year-old patient following laparoscopic cholecystectomy, who excreted (on his own) a cotton sheet 30×65 cm after 26 weeks, which did not possess a radiological locator. The latter fact caused diagnostic difficulties in interpreting ultrasonography, CT-scans and abdominal X-rays. Colonoscopy after 4 months following the excretion of the sheet showed flat, stretched ulceration of the colonic wall near the hepatic turn.
The second case is a 76-year-old who had undergone several abdominal surgeries, including a classical cholecystectomy and extirpation of the uterus along with related tissues, as a result of cancer and with subsequent radiotherapy. The reason for the last intervention was an occlusion, which required a resection due to abscesses inside the peritoneal cavity. Abdominal pain continued after the surgery. Uroscopy and abdominal X-rays were performed 3 months later, which confirmed the presence of foreign matter in the abdominal cavity.
Conclusions: Most foreign objects that have migrated into the colon will be excreted autonomously, which warrants a conservative assessment. Radiologically-tagged materials should be used, which will greatly ease identification in cases of suspected retention of surgical materials in the abdominal cavity.

Keywords: Foreign-Body Migration - pathology, Colon - radiography, Radiography, Abdominal, Tomography, X-Ray Computed

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