Varetto Lorenzo, Gargallo Claudio
Department of Anatomy, Pharmacology and Forensic Medicine, University of Turin, 10126 Turin, Italy.
Forensic Sci Int. 2009 Oct 30;191(1-3):e11-3. doi: 10.1016/j.forsciint.2009.07.011. Epub 2009 Aug 13.
This case relates to an intra-abdominal foreign body which was detected in a patient. The patient claimed that this was a needle which had been negligently left in his abdomen by a surgical team following an appendectomy which had been performed 13 years previously (in 1994). A radiograph was taken in 2007 and compared against the pre-operative radiograph which had been taken in 1994. This showed that the foreign body had been in the patient's body prior to the appendectomy being performed. The foreign body was extracted from the patient's liver through laparoscopic surgery in 2007. Examination of the fragments revealed that the foreign body was a sewing needle. Medical literature suggests that the needle may have accidentally been ingested by the patient. This is a rare case of a migrated swallowed foreign body (there are only 46 similar cases reported worldwide). It is of interest that the patient's immediate reaction was to assume that this was a case of medical malpractice. This report discusses issues relating to this case that were raised during the criminal proceedings relating to the medical negligence claim.
该病例涉及一名患者体内检测到的腹腔内异物。患者称这是一枚针，13年前（1994年）进行阑尾切除术后，外科手术团队疏忽将其遗留在他的腹部。2007年拍摄了一张X光片，并与1994年术前拍摄的X光片进行对比。结果显示，在进行阑尾切除术之前，异物就已存在于患者体内。2007年通过腹腔镜手术从患者肝脏中取出了异物。对碎片的检查表明，异物是一枚缝纫针。医学文献表明，这枚针可能是患者意外吞食的。这是一例罕见的迁移性吞食异物病例（全球仅报告了46例类似病例）。有趣的是，患者的第一反应是认为这是一起医疗事故。本报告讨论了在与医疗过失索赔相关的刑事诉讼中出现的与该病例有关的问题。
