Case Report
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jan 26, 2024; 12(3): 596-600
Published online Jan 26, 2024. doi: 10.12998/wjcc.v12.i3.596
Removal of a guide-wire sliding into abdominal cavity via transgastric natural orifice transluminal endoscopic surgery: A case report
Shi-Ju Chen, Da-Ya Zhang, Yan-Ting Lv, Fei-Hu Bai
Shi-Ju Chen, Da-Ya Zhang, Yan-Ting Lv, Graduate School, Hainan Medical University, Haikou 571199, Hainan Province, China
Fei-Hu Bai, Department of Gastroenterology, The Second Affiliated Hospital of Hainan Medical University, 570216 Haikou, Hainan Province, China
Fei-Hu Bai, Department of Gastroenterology, Clinical Medical Center of Hainan Province, Haikou 570216, Hainan Province, China
Author contributions: Chen SJ, Zhang DY and Lv YT participated in the research design; Chen SJ, Zhang DY, Lv YT and Bai FH participated in the performance of the research and in the data analysis; Zhang DY and Lv YT participated in the writing of the article; Chen SJ, Zhang DY and Lv YT contributed equally to this work.
Supported by the Specific Research Fund of The Innovation Platform for Academicians of Hainan Province, No. YSPTZX202313; Hainan Province Clinical Medical Center, No. 2021818; Hainan Provincial Health Industry Research Project, No. 22A200078; and Hainan Provincial Postgraduate Innovation Research Project, No. Qhyb2022-133.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All authors disclosed no financial relationships.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Fei-Hu Bai, Doctor, Chief Physician, Department of Gastroenterology, The Second Affiliated Hospital of Hainan Medical University, Yehai Avenue, No. 368 Longhua District, 570216 Haikou, Hainan Province, China. baifeihu_hy@163.com
Received: October 3, 2023
Peer-review started: October 3, 2023
First decision: December 6, 2023
Revised: December 16, 2023
Accepted: January 4, 2024
Article in press: January 4, 2024
Published online: January 26, 2024
Processing time: 106 Days and 19.1 Hours
Abstract
BACKGROUND

Guidewire slippage into the peritoneal cavity during clinical operations is extremely rare. Therefore, this paper aims to report a successful case of guidewire removal using transgastric natural orifice transluminal endoscopic surgery (NOTES). The goal is to enhance physicians' understanding of the management plan for this unique scenario and provide a valuable reference for clinical practice.

CASE SUMMARY

A 64-year-old man presented with abdominal distension and was diagnosed with cirrhosis combined with massive ascites. To proceed with treatment, the patient underwent ultrasound-guided peritoneal puncture and underwent catheterization and drainage. Unfortunately, a 0.035-inch guidewire slipped into the abdominal cavity during the procedure. Following a comprehensive evaluation and consultation by a multidisciplinary team, the guidewire was successfully removed using NOTES.

CONCLUSION

This case highlights the potential consideration of transgastric NOTES removal when encountering a foreign body, such as a guidewire, within the abdominal cavity.

Keywords: Guidewire; Abdominal cavity; Natural orifice transluminal endoscopic surgery; Cirrhosis; Massive ascites; Case report

Core Tip: Guidewires play a crucial role in facilitating various medical procedures. Whereas previous reports primarily focused on guidewire breakage and subsequent entrapment within peripheral blood vessels during interventional procedures, this case highlights a unique incident where a guidewire slipped into the abdominal cavity. After extensive multidisciplinary consultations, which took into account the patient's age, frail physical condition, and fair coagulation function, the abdominal guidewire was successfully removed using natural orifice transluminal endoscopic surgery in accordance with individual wishes of the patient. Consequently, the patient experienced a smooth recovery without fever or abdominal pain. This comprehensive article meticulously delineates the management of this exceptional case, which presents an inevitable scenario in clinical practice, ultimately offering valuable insights for healthcare practitioners.