Paediatric Surgery Unit, University Children's Hospital of Geneva, 1211 Geneva, Switzerland.
J Pediatr Surg. 2009 Nov;44(11):e17-20. doi: 10.1016/j.jpedsurg.2009.10.052.
We report on a 3-year-old boy who, after ingestion of turpentine, had an x-ray and was incidentally diagnosed with an intrahepatic needle. He was asymptomatic with no history of needle ingestion. Imaging (ultrasound and computed tomographic scans) showed a needle in segment 1, close to the inferior vena cava, with a proximal end in contact with the superior angle of the duodenum. Because of the localization of the needle and subsequent risks of complications, removal was proposed. Laparoscopy showed dense adhesions between liver and duodenum, confirming the migration route. Laparoscopic extraction of an entire sewing needle was performed. Postoperative course was uneventful; the child was discharged home after 2 days and is alive and well 19 months after surgery. Laparoscopy may be useful in children for extraction of intrahepatic foreign bodies, after transduodenal migration.
我们报告了一例 3 岁男孩，他在摄入松节油后接受了 X 光检查，意外诊断出肝内有一根针。他无症状，没有吞食针的病史。影像学（超声和 CT 扫描）显示一根针位于第 1 段，靠近下腔静脉，近端与十二指肠上缘接触。由于针的位置和随后并发症的风险，建议取出。腹腔镜检查显示肝和十二指肠之间有密集的粘连，证实了针的迁移路径。通过腹腔镜成功取出了整根缝针。术后恢复顺利，患儿术后 2 天出院，术后 19 个月时情况良好。对于经十二指肠迁移的肝内异物，腹腔镜可能对儿童的取出有用。
