Surgical paper XIII
Ingested lighter as a foreign body in the stomach
A Case Report
Case presentation
A 22-year-old male, generally in good health, intentionally ingested a wire resistance lighter two months prior to admission. He manually forced the object through his pharynx, facilitating its smooth passage into the stomach without experiencing obstruction, bleeding, or esophageal injury. Despite consuming a large quantity of leeks that evening, the foreign body was not naturally expelled and he experienced no immediate discomfort. One month later, he began experiencing abdominal pain on an empty stomach, which was alleviated by eating. An abdominal X-ray at our institution confirmed the object's retention in the stomach. Surgical intervention was deferred until two months later, given the absence of acute symptoms.
Clinical Examination
Upon physical examination, the patient appeared generally well, with no upper abdominal tenderness. Abdominal X-ray and B-type ultrasonic gastric perfusion examination confirmed the presence of the foreign body within the stomach.
Surgical Procedure
On July 4, 1991, under epidural anesthesia, a 3.5 cm gastric incision was made. The gastric mucosa appeared slightly congested, but there were no signs of ulceration or hyperplasia. The foreign object, not adhered to the gastric wall, was successfully retrieved under direct visualization and the stomach was subsequently repaired. The postoperative course was uneventful, with sutures removed on day seven.
Pathological Findings
The retrieved foreign body was identified as a wire resistance lighter, measuring 7x3x1.5 cm and weighing 18 grams. It was composed of a blend of plastic and metal. Erosion was evident on its metal shell, and part of the plastic had been stripped away.
Discussion
The smooth passage of a rigid foreign body with a 3 cm transverse diameter through the pharynx and esophagus without injury is notable. However, the object remained in the stomach for an extended period, unable to pass through the pylorus. Stomach acid had corroded both the metal and plastic components of the lighter, although it remained largely intact due to its composite nature. Endoscopic retrieval was considered but deemed risky due to the potential for iatrogenic injury. Surgical removal proved to be a safe and effective approach, with a favorable prognosis confirmed at a three-month follow-up.
1991/10/15 Changhang Hospital, Li Mingjie & Wang Yisheng
from 胃内打火机异物一例
