RETAINED FOREIGN BODIES

AFTER INTRAABDOMINAL SURGERY - A CONTINUING PROBLEM

Abstract

Objectives: (1) To look into clinical presentations of intra-abdominal foreign bodies; (2) To document surgical procedure performed. (3) To see measures for prevention. Design: Observational case series. Setting: Bahawal Victoria Hospital Bahawalpur. Period: From 1.06.07 to 31.5.08. Patient & Methods: Eleven patients with retained having intra-abdominal foreign body were treated. Relevant history, clinical examination and necessary investigations were done. Exploratory laparotomy was done in 10 cases to remove the foreign body and in one case foreign body passed from the rectum without laparotomy. Results: Out of 11 cases, 54.54% are males and 45.45% were females. Operated in emergency 81.81% and elective 18.18%. 90.91% were operated in periphery and 9.09% in the tertiary care centre. Clinical presentations were intestinal obstruction (27.27%), intraabdominal abscess (13.18%), Discharging sinus (18.18%), mass abdomen (18.18%),
entero cutaneous fistula (9.09%), peritonitis (9.09%). Exploratory laparotomy was done in 90.91%, to remove the foreign body and in 1 case passed per rectum. Conclusions: Retained foreign bodies presented as intestinal obstruction, abscess, sinus fistula mass, or peritonitis. It is avoidable iatrogenic surgical complication, mostly found in operations done in emergency and at peripheral hospitals. Exploratory laparotomy remains the mainstay of treatment to remove the intra-abdominal foreign body. Surgeon should be vigilant to avoid mishap by check on counting, tucking sponge, blackboard counting, examining abdomen, screening in suspicious case and claim for radio-opaque sponges.Referral system needs improvements for in time adequate treatment.