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A Journal on Surgery

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Chirurgia 2004 June;17(3):107-10


language: Italian

Spontaneous migration of a osteosyntheses wire from the hip to the retroperitoneal space. A case report

Schlesinger S., Calipari G., Beccaria A., Albanese V., Cuci-notta F., Famà F., Gioffrè Floriot M. A.


Migration of foreign bodies is often debated in the medical literature. In this case report, a spontaneous migration of a Kirschner wire from the right hip to the retroperitoneal space, without causing any apparent symptoms or lesion to vital organs, is observed. The clinical case of a 65-year-old male, with hypertension and diabetes, submitted to osteosynthesis according to Kirschner in 1983 at the right femoral neck, is reported. Postoperative time was regular but a claudication remained. The patient was admitted, after 17 years, at our Emergency Service for abdominal pain with prevalent localization on the right quadrants; Murphy's, Blumberg's, Giordano's and urinary tract signs were negative. Abdominal X-ray was unremarkable for hydro-air levels and gas distension of intestinal loops, but a metallic foreign body was found situated in the retroperitoneal space in correspondence of the hepatic shadow. The patient was hospitalized for further investigations and treatments. In this case, it is suggested that the main ‹ but not the only ‹ factor responsible for the foreign body intermuscular migration, across muscular surfaces with the final localization between the posterior abdominal wall, the liver and the right kidney, without vital organs lesions, was the residual chronic claudication. This atypical migration is specific for clinical symptomatology related to the presence of a foreign body. The importance of a clinical instrumental follow-up in patients with osteosynthesis is undelined.

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