A sewing needle within the right hepatic lobe of an infant

Pediatr Emerg Care. 2013 Sep;29(9):1013-5. doi: 10.1097/PEC.0b013e3182a35eea.

Abstract

Intrahepatic foreign bodies are extremely rare before 6 months of age. We reported a case of a 5-month-old boy with a needle-like foreign body in the liver. The foreign body was incidentally found in the right hepatic lobe on the x-ray image. He was asymptomatic, with neither a history of swallowing a needle nor an abdominal cutaneous scar. Three-dimensional reconstruction of spiral computed tomographic scan showed an intrahepatic needle, close to the base of the heart, with its proximal end close to the gallbladder fossae. Because of the localization of the needle and subsequent risks of complications, surgical removal was recommended. At laparotomy, a tiny scar was recognized in the upper surface of the right lobe of the liver, confirming the migration route. Postoperative course was uneventful, and the child was discharged on postoperative day 10 and is thriving perfectly 2 months after surgery. We reviewed the clinical issues of intrahepatic foreign bodies and briefly discussed its approach and implications.

Publication types

  • Case Reports

MeSH terms

  • Abdominal Injuries / complications
  • Anti-Bacterial Agents / therapeutic use
  • Asymptomatic Diseases
  • Cefamandole / analogs & derivatives
  • Cefamandole / therapeutic use
  • Emergencies
  • Foreign Bodies / diagnostic imaging*
  • Foreign Bodies / surgery
  • Foreign-Body Migration / diagnosis
  • Humans
  • Image Processing, Computer-Assisted
  • Incidental Findings
  • Infant
  • Laparotomy
  • Liver / diagnostic imaging*
  • Liver / surgery
  • Liver Function Tests
  • Male
  • Needles
  • Respiratory Tract Infections / diagnostic imaging
  • Tomography, Spiral Computed
  • Wound Infection / drug therapy
  • Wound Infection / etiology

Substances

  • Anti-Bacterial Agents
  • Cefamandole
  • cefamandole nafate