• Ewoud Jutte and Huib Cense.
• Department of Surgery, Red Cross Hospital, Beverwijk, The Netherlands. ejutte@rkz.nl
• ScientificWorldJournal. 2010 Aug 3; 10: 1532-4.

AbstractA 45-year-old female was admitted to the hospital with a 1-week history of right upper abdominal pain and nausea. Ultrasonography showed a thickened duodenum with infiltration. Subsequent gastroscopy did not reveal any abnormalities. CT scan showed a foreign body perforation at the duodenum and a liver abscess (Fig. 1A,B). A diagnostic laparoscopy was performed. During the operation, the abscess was drained (Fig. 2A,B) and a sewing needle was removed (Fig. 3A,B). The patient claimed to have no recollection of swallowing the needle and made a quick recovery. Although rare, gastrointestinal perforations due to ingested foreign bodies most frequently occur at ileocecal, rectosigmoid, and duodenal regions[1]. Sewing needle perforations into the liver have been reported in children, adults, and psychiatric cases. Symptoms can vary from mild gastric pain to signs of peritonitis[2]. "Wait and see" is recommended for asymptomatic patients with no complications. Symptomatic patients (e.g., liver abscess) need surgical intervention[1,2,3].

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