Laparoscopic removal of a needle from the pancreas
A 28 -year-old lady presented with pain in the epigastric region for 3 months which was not associated with heartburn, vomiting, fever, jaundice, haematemesis, melena, etc. She had a caesarean delivery two years back. Her physical examination and routine blood tests including haemogram, renal function test, liver function test, serum amylase and lipase were normal. X-ray of the abdomen (AP view) revealed a linear radio-opaque shadow in across T11 and T12 vertebrae []. Her CECT abdomen showed a 3.8 cm sized linear metallic density object inside the head of pancreas []. Her endoscopic examination, with both end and side viewing scopes, failed to localise any object inside the stomach and duodenum. Patient was planned for laparoscopic removal of the foreign body, lesser sac was approached through the gastro colic ligament, stomach and first part of duodenum dissected away from the pancreas, after that tip of the object could be felt by the instrument. Careful dissection was done to visualise the object and once in sight, it was removed with the help of Maryland dissector under vision and bleeding was controlled by pressure with a gauge []. Post-operative period was uneventful and the patient was allowed orals after 6 hours and discharged on second post-operative day. She is doing well for 1 year after the surgery.