Laparoscopic retrieval of an intra-abdominal sewing needle following unrecognized penetration: a case report

Unrecognized transcutaneous penetration by a small sharp foreign body is rare and may present without a clear history of injury. A 50-year-old woman presented with abdominal pain and was found to have a 4-cm linear metallic foreign body within the peritoneal cavity. After initial observation, she represented with recurrent pain and radiographic migration of the object, later recalling that she may have rolled onto a sewing needle while asleep. At diagnostic laparoscopy the needle was not immediately visible. Sequential intraoperative radiographs, using a laparoscopic grasper as a radiopaque reference point, enabled localization of the needle within greater omentum adjacent to the transverse colon. It was removed laparoscopically without visceral injury. This case demonstrates the value of targeted intraoperative radiography when a small radiopaque foreign body cannot be identified during minimally invasive exploration.