Laparoscopic removal of a foreign body from the jejunum.

Swallowed foreign bodies evacuate spontaneously; therefore, their removal is necessary only if a complication is under suspicion or has ensued. A man of 22 years swallowed, with suicidal intentions, the 9-cm-long and 1.5-cm-wide blade of his pocket knife, which, according to repeated x-ray investigations, was impacted partly through the pylorus into the duodenum. Because of the symptoms, perforation could not be excluded, so laparoscopic removal was decided on. The blade meanwhile passed into the jejunum and was localized intraoperatively with a c-arm fluoroscope. After jejunotomy and removal of the blade, the opening of the small bowel was closed with intracorporeal hand-suturing technique. Postoperative recovery was quick and uneventful. On the evidence of the case history presented, the laparoscopic removal of a foreign body from the gastrointestinal tract can be judged a convenient procedure.