Misinterpretation of a pulmonary GI anastomosis stapler line as a retained foreign body.

Intraoperatively retained foreign bodies are both medical and medico-legal problems. We report a patient who underwent a lower left lobectomy initially for nonresolving chronic organizing pneumonia. Rethoracotomy was performed due to a suspicious CT finding of a retained surgical sponge that turned out to be a GI anastomosis (GIA) staple line.

The nifedipine-rifampin interaction. Evidence for induction of gut wall metabolism.

The calcium channel blocker nifedipine is metabolized by cytochrome P450 3A4, which is present in liver and mucosa of the small bowel. Cytochrome P450 3A4 is inducible by the tuberculostatic rifampin in liver and the small bowel. The contribution of gut wall metabolism to total clearance of nifedipine before and during induction has not been determined in detail.