LAPALOSCOPIC REMOVAL OF FOREIGN BODY IN A PATIENT ACCOMPANIED WITH VON WILLEBRAND'S DISEASE

We report a successful application of laparoscopic removal of a foreign body from a patient with von Willwbrand's disease. A 40-year-old man was admitted to the hospital for further evalation of a radiopaque lesion revealed on an abdominal X-ray during a rutine medical checkup in September 1993. He had occasions experienced a dull pain in his back three months prior to admission. He had been suffering from a bleeding diathesis since childhood, however, he had never sought medical advice. Furthermore, there was no previous history of undergoing laparotomy. Upper gastrointestinal series and abdominal CT revealed a foreign body that appeared to be a needle surrounded by the greater omentum in the abdominal cavity. From hemostatic studies, he was diagnosed as having von Willebrand's disease (type I). We thought that this needle should not be left untreated, because of the risk that he might fall into a critical condition if there were abdominal bleeding under this hemorrhagic diathesis. By antihemophlic factor VIII (Haemate®P) therapy, the patient had a laparoscopic removal of this foreign body resecting with the greater omentum in January 1994. The patient had an uneventful postoperative course and was discharged from the hospital 10 days after the surgery.