Guide Wire Left Behind After Abscess Drainage Procedure

This case involves a 9-year-old female patient who presented to the hospital with a ruptured appendix. Additionally, an abscess was identified in her abdomen prior to surgery and an Interventional Radiologist was consulted to drain the abscess; the appendix was removed after the drainage. Several months later, after continual complaints of abdominal pain, the patient had an x-ray taken which revealed a linear object in her abdomen. Shortly after its discovery, the patient experienced increasing pain and rectal bleeding attributed to an embedded guide wire that was not removed during the original drainage procedure.

Question(s) For Expert Witness

1. Is this a common complication?

2. What measures are taken to prevent such complications?

Expert Witness Response E-004038

The wire is usually removed at the time of the drainage procedure. However, sometimes wires do break. If that happens a discussion should occur with the surgeon to possibly remove it at surgery or sometimes it is left in place if it is inaccessible. Retrained wire fragments rarely cause problems but can as it apparently did in this case. The wire being left in the abdomen is quite an unusual circumstance and extremely rare in my experience. It should have been noticed earlier (at the time of drain placement or removal or on subsequent films). Also, I would like to add that it should have been disclosed to the patient/family as soon as possible.