Xu Bi-Jun, Lü Cheng-Jie, Liu Wei-Guang, Shu Qiang, Zhang Yue-Bing
From the Departments of *Cardiothoracic Surgery, and †General Surgery, Children's Hospital, Zhejiang University School of Medicine, Hangzhou City, Zhejiang Province, China.
Pediatr Emerg Care. 2013 Sep;29(9):1013-5. doi: 10.1097/PEC.0b013e3182a35eea.
Intrahepatic foreign bodies are extremely rare before 6 months of age. We reported a case of a 5-month-old boy with a needle-like foreign body in the liver. The foreign body was incidentally found in the right hepatic lobe on the x-ray image. He was asymptomatic, with neither a history of swallowing a needle nor an abdominal cutaneous scar. Three-dimensional reconstruction of spiral computed tomographic scan showed an intrahepatic needle, close to the base of the heart, with its proximal end close to the gallbladder fossae. Because of the localization of the needle and subsequent risks of complications, surgical removal was recommended. At laparotomy, a tiny scar was recognized in the upper surface of the right lobe of the liver, confirming the migration route. Postoperative course was uneventful, and the child was discharged on postoperative day 10 and is thriving perfectly 2 months after surgery. We reviewed the clinical issues of intrahepatic foreign bodies and briefly discussed its approach and implications.
肝内异物在6个月龄前极为罕见。我们报告了1例5个月大的男孩肝脏内有针状异物的病例。该异物在X线图像上偶然发现于右肝叶。他没有症状，既无吞针史也无腹部皮肤瘢痕。螺旋CT扫描三维重建显示肝内有一枚针，靠近心脏基部，其近端靠近胆囊窝。由于针的位置及后续并发症风险，建议手术取出。剖腹手术时，在肝右叶上表面发现一个微小瘢痕，证实了异物的迁移路径。术后过程顺利，患儿于术后第10天出院，术后2个月生长发育良好。我们回顾了肝内异物的临床问题，并简要讨论了其处理方法及意义。
