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Intra-abdominal needle: medical malpractice?

Lorenzo Varetto1, Claudio Gargallo

  • 1Department of Anatomy, Pharmacology and Forensic Medicine, University of Turin, 10126 Turin, Italy. lorenzo.varetto@unito.it

Forensic Science International
|August 18, 2009
PubMed
Summary

A migrated sewing needle, swallowed and lodged in the liver for 13 years, was successfully removed via laparoscopic surgery. This rare intra-abdominal foreign body case highlights diagnostic challenges and patient perception of medical negligence.

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Area of Science:

  • Gastroenterology
  • Surgical Pathology
  • Medical Imaging

Background:

  • A patient presented with a suspected intra-abdominal foreign body attributed to a prior appendectomy.
  • The foreign body was claimed to be a surgical needle left during a 1994 appendectomy.

Observation:

  • Radiographic comparison of 1994 and 2007 images revealed the foreign body predated the appendectomy.
  • The foreign body was located within the liver and extracted using laparoscopic surgery in 2007.
  • Examination identified the foreign body as a sewing needle.

Findings:

  • The case represents a rare instance of a migrated swallowed foreign body, with only 46 similar cases reported globally.
  • Evidence suggests the sewing needle was likely ingested and migrated, not a surgical complication.

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Implications:

  • This case underscores the importance of thorough patient history and diagnostic imaging in identifying foreign bodies.
  • It raises questions about patient perception of medical malpractice versus rare medical occurrences.
  • The report discusses legal and ethical considerations arising from medical negligence claims in complex foreign body cases.