Endoscopic Removal of a Duodenal-Perforating Leg of Glasses with Dormia Basket

Abstract

Ingestion of foreign bodies is common in clinical practice. Most ingested foreign bodies will pass through the gastrointestinal (GI) tract without any problems. While GI tract injury due to the ingested foreign body such as a toothpick, a fishbone, a date pit, or a chicken bone, is common, duodenal perforation is rare. In this report, our experience with this rare entity is shared. We present a 38-year-old male patient with GI tract perforation in the bulbus of the duodenum due to a leg of glasses. The patient was admitted to our hospital with severe abdominal pain. Right upper quadrant tenderness was detected at physical examination, and leukocytosis on the laboratory test results. Plain X-ray and computerized tomography showed an ingested foreign body in the bulbus of the duodenum. A leg of glasses perforating the duodenum was removed with endoscopy. The patient was managed nonoperatively, and discharged without any complications on the eighth day after endoscopy. Endoscopic removal and nonoperative management may be feasible in carefully selected patients with duodenal-perforating foreign bodies.

Keywords: Duodenal perforation; Endoscopic removal; Foreign body.

Fig. 1

Standing X-ray films showed a metal shadow in the right abdominal quadrant between the third lumbar vertebra and the fifth lumbar vertebra level.

Fig. 2

CT findings: a linear hyperdense foreign body penetrating the entire bowel wall at the duodenum.

Fig. 3

a Endoscopic image showing a black foreign body lodged in the bulbus of the duodenum and purulent secretions surrounding the foreign body. b A leg of glasses after its removal.