Migrazione spontanea di un mezzo di osteosintesi dall'anca allo spazio retroperitoneale. Un caso clinico [Spontaneous migration of a osteosyntheses wire from the hip to the retroperitoneal space. A case report]

AIM AND BACKGROUND Migration of foreign bodies is often debated in the medical literature. In this case report we observed 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. CASE REPORT We reported a clinical case of a male I.P. 65 years old, with Hypertension and Diabetes, submitted to an osteosynthesis by Kirshner method in 1983 at the right femoral neck. Postoperative time was regular but a claudicatio remained . The patient arrived, 17 years after, at our Emergency Service with abdominal pains 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 on a surgical ward for further investigations and treatments. DISCUSSION In this case we supposed that the main - but not the only – factor responsible for the foreign body intermuscular migration - across muscular surfaces with final localization between the posterior abdominal wall, the liver and the right kidney, without vital organs lesions - was the residual chronic claudicatio. CONCLUSION This athipical migration is a specific for clinical sinthomatology related at the presence of a foreign body. We underline the importance of a clinical-instrumental follow-up in patients with osteosynthesis