A rare case of retained metallic foreign body in liver: case report and review of literature

Author:

Dev Santosh1,Yadav Manish1,Shah Newton Ashish1,Dev Barsha2,Devkota Shishir1,Khadka Laxman1,Das Dhiraj Kumar3,Yadav Samridhi4,Sah Jayant Kumar5,Ghimire Bikal5

Affiliation:

1. Tribhuvan University, Institute of Medicine

2. Nepalgunj Medical College Teaching Hospital, Kohalpur

3. Universal College of Medical Sciences, Siddharthanagar

4. National Medical College, Birgunj, Nepal

5. Tribhuvan University Teaching Hospital, Kathmandu

Abstract

Introduction and importance: Foreign bodies in the liver are uncommon but can lead to severe conditions like liver abscess and sepsis. They typically enter through direct penetration, migration from the gastrointestinal tract, or through the blood. Common foreign objects include metal pins, or sewing needles swallowed accidentally. Case presentation: A 25-year-old male presented to our OPD with pain over the right abdomen with a prior history of projectile injury causing laceration over the right anterior abdomen with primary suturing. On radiological investigation, a retained foreign body was revealed. The metallic foreign body was embedded in the liver for 5 months. Removal of the foreign body was performed without any complications. Clinical discussion: Intrahepatic foreign bodies (FBs) in the liver can result from penetrating injuries, iatrogenic causes, or ingestion, particularly in children. Clinical presentations vary, and complications such as abscess formation may occur. Diagnosis involves imaging modalities like X-rays, ultrasonography, and computed tomography (CT) scans. The presented case highlights the importance of meticulous follow-up, as chronic pain manifested despite conservative management. The management of intrahepatic FBs depends on factors like size, location, and symptoms, with conservative approaches for stable patients. Surgical removal remains the mainstay of the treatment. Long-term monitoring is crucial to detect potential complications, and imaging studies play a key role in regular follow-up. Conclusion: Hepatic foreign bodies are rare, and symptoms vary based on size, type, and location, ranging from asymptomatic to complications such as abscess formation. Surgical removal is the main treatment, but in cases of noncomplicated hepatic foreign bodies, close follow-up is necessary.

Publisher

Ovid Technologies (Wolters Kluwer Health)

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