Complete abdominal exploratory revealed a focal area suspicious of an intestinal foreign body. The oral bowel appeared hyperemic (almost hemorrhagic) from trauma induced by migration of the sharply pointed foreign body throughout the small intestine. The aboral bowel appeared viable, although hyperemic.
Once the foreign body was located, a complete exploratory laparotomy was performed to rule out the presence of additional foreign bodies. No other foreign bodies were noted, and the surgeon elected to perform an enterotomy to remove the single foreign body.
The section of bowel containing the foreign body was exteriorized and packed-off. A careful longitudinal incision was then made through the antimesenteric border of the aboral intestine, avoiding any unhealthy bowel. After incision, the foreign body was manipulated and removed through the enterotomy site using Allis tissue forceps.
Closure of the bowel wall was performed using a simple continuous appositional suture pattern, starting and finishing beyond each commissure of the incision. Each bite was taken 3-mm beyond the cut edge of the serosa and into the lumen of the intestine, with each suture placed no further than 2- to 3-mm apart. The last throw was made beyond the commissure of the enterotomy site.
After local lavage and inspection of the enterotomy site, the entire abdominal cavity was lavaged and the laparotomy site was closed routinely. Simple continuous appositional suture patterns were used for closure of both the body wall and the skin.
