2022 Volume 42 Issue 7 Pages 749-752
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.
