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Re: Bic Pen From: Eugene S. Jursek (ejursek@neoucom.edu) Fri Dec 22 17:09:40 2000 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Luis Sanchez-Ramos, MD: "Re: Labor-Inducing Drug Associated With 8 Deaths" Previous message: John Robertson MD: "Re: Bic Pen" Maybe in reply to: ainsron@msn.com: "Bic Pen" Next in thread: Geffrey Klein, MD: "Re: Bic Pen" Reply: Geffrey Klein, MD: "Re: Bic Pen" I am sure all of us in practice have seen the unusual as in this case. When I was a first year resident one evening the chief resident called me to look at an Xray. The film was a flat plate of the abdomen and a baseball bat was seen on the plate. It was approximately 16 inches long and had a diameter of about 2 inches. I, then in my sophomoric wisdom, told the chief that they somehow superimposed the bat on the abdomen. BUT, voila, that was not so. The bat was intraperitoneal. Point of entry was the vagina. The entry was the anterior fornix, between the bladder and the anterior uterine wall, between the ureters and the uterine arteries. Neither of these structures were torn or ruptured. The passageway was clean from vagina into the abdomen. The "story" from the patient was that she was cleaning the bathtub, somehow slipped and thus impregnated herself with the plastic bat. Laparotomy showed that the bladder, the ureters, uterine arteries were intact; there was a miniscule amount of blood in the peritoneal cavity and a rent in the peritoneum between the bladder and the ant. uterine wall. Patient recovered without any other mishap. We diagnosed this case as an "ectopic bat". >===== Original Message From ob-gyn-l@obgyn.net ===== >Interesting what happens when people get too much holiday cheer. I was >called to assist a urologist in the OR today, a 41 yo WF came in to the >ER early this AM with a blood alcohol of 0.15 and apparently while she >was passed out, her friend/lover/partner pushed a Bic pen up "the small >hole." She was having a fair amount of pain, afebrile, with a WBC of >15,000. The urologist initially did a cystoscopy and couldn't find a >hole in the bladder. An abdominal flat plate showed the foreign body >somewhere in the abdominal cavity. Because they didn't initially find a >bladder perforation, a gastroenterologist was called in and a air >contrast BE performed which did not show anything in the colon. She was >next taken to the OR and I was called at this point to help look for the >pen. We found it floating freely among the loops of small bowel and >about 500 cc of the irrigant used for the cystoscopy which was within >the peritoneal cavity. The pen was easily retrieved with a babcock >forceps through a 10mm port and removed. There was no bleeding from the >now easily identified opening into the dome of the bladder, as we filled >her bladder with saline and watched it leave the bladder. The plan is >to cover her with antibiotics for a few days, drain the bladder with a >Foley for 5-7 days. > >-- >Ronald E. Ainsworth, MD Ciao. Geno Next message: Luis Sanchez-Ramos, MD: "Re: Labor-Inducing Drug Associated With 8 Deaths" Previous message: John Robertson MD: "Re: Bic Pen" Maybe in reply to: ainsron@msn.com: "Bic Pen" Next in thread: Geffrey Klein, MD: "Re: Bic Pen" Reply: Geffrey Klein, MD: "Re: Bic Pen"

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