Pyloromyotomy-assisted extraction of a neglected giant duodenal spoon complicated by delayed adhesive small bowel obstruction: a case report
Abstract
Intentional ingestion of long gastrointestinal foreign bodies is uncommon in adults. Giant spoon impaction in the duodenum is exceptionally rare and usually requires surgery. A 28-year-old man intentionally ingested an 18-cm metallic spoon. Computed tomography demonstrated impaction in the second part of the duodenum. After initially refusing surgery, repeat imaging suggested extra-luminal extension. Laparotomy with complete Kocher mobilization enabled extraction through a pyloromyotomy, avoiding duodenotomy, followed by Heineke–Mikulicz pyloroplasty. He was discharged on postoperative day seven. Two and a half months later, he developed adhesive small bowel obstruction requiring adhesiolysis, with an uneventful recovery. Pyloromyotomy-assisted extraction is a feasible alternative for selected giant duodenal foreign bodies when endoscopic retrieval is not possible. This case also emphasizes the need for long-term follow-up because delayed adhesive small bowel obstruction may occur after laparotomy.
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BibTeX
@article{zamani2026pyloromyotomyassisted,
title = {{Pyloromyotomy-assisted extraction of a neglected giant duodenal spoon complicated by delayed adhesive small bowel obstruction: a case report}},
author = {Amir Zamani and Seyed Mahdi Tabatabaei Naeini and Milad Dodangeh},
journal = {Journal of Surgical Case Reports},
year = {2026},
month = oct,
doi = {10.1093/jscr/rjag939},
url = {https://doi.org/10.1093/jscr/rjag939},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Pyloromyotomy-assisted extraction of a neglected giant duodenal spoon complicated by delayed adhesive small bowel obstruction: a case report
AU - Amir Zamani
AU - Seyed Mahdi Tabatabaei Naeini
AU - Milad Dodangeh
PY - 2026
DA - 2026/10/22
JO - Journal of Surgical Case Reports
DO - 10.1093/jscr/rjag939
UR - https://doi.org/10.1093/jscr/rjag939
AB - Intentional ingestion of long gastrointestinal foreign bodies is uncommon in adults. Giant spoon impaction in the duodenum is exceptionally rare and usually requires surgery. A 28-year-old man intentionally ingested an 18-cm metallic spoon. Computed tomography demonstrated impaction in the second part of the duodenum. After initially refusing surgery, repeat imaging suggested extra-luminal extension. Laparotomy with complete Kocher mobilization enabled extraction through a pyloromyotomy, avoiding duodenotomy, followed by Heineke–Mikulicz pyloroplasty. He was discharged on postoperative day seven. Two and a half months later, he developed adhesive small bowel obstruction requiring adhesiolysis, with an uneventful recovery. Pyloromyotomy-assisted extraction is a feasible alternative for selected giant duodenal foreign bodies when endoscopic retrieval is not possible. This case also emphasizes the need for long-term follow-up because delayed adhesive small bowel obstruction may occur after laparotomy.
SN - 2042-8812
ER -