A Case Report of the Retrieval of a Duodenal Foreign Body from the Liver

A 27-year-old female patient from a psychiatric unit presented with a two-week history of abdominal pain and worsening nausea. She admitted to swallowing a ballpoint pen five months prior. Endoscopy showed the tip of the pen impacted in the superior wall of the first part of the duodenum. The endoscopist elected not to retrieve the foreign object and a computed tomograph (CT) was organised. This showed migration of the pen into the liver with the tip in close proximity to the portal vein. Laparoscopic surgery was performed to remove the pen with minimal blood loss. The patient was discharged 12 days later. This case highlights the presence of guidelines to aid decision-making in retrieval of ingested foreign bodies and the value of additional imaging to guide management of foreign body ingestions.