侵入経路の同定が困難であった腹腔内異物に対して腹腔鏡下手術が有用であった1例

A woman in her 50s presented with left flank pain after eating fish. She was hospitalized by clinical suspicion of small-intestinal penetration by a fish bone, diagnosed with a CT scan. Physical examination on her initial visit revealed mild abdominal tenderness in her left flank region. On the same day, a CT image revealed a high-density line substance in the left middle abdomen, suggesting the presence of a fish bone. A fluoroscopy revealed a long and narrow foreign body, which was clearer than a fish bone, in the left of the umbilicus. Under a diagnosis of peritonitis related to small intestinal penetration by a metallic foreign body, we performed emergency surgery. After we examined the peritoneal cavity under a laparoscope, we detected a needle-like substance in the greater omentum of the left flank, and removed. It was identified as a metallic wire.