Figs 2 - uploaded by Ac Can Başaklar
Content may be subject to copyright.
a and 2b. Schematic representation of the new technique an orogastric tube was inserted into the stomach (2a) and the open end SP was pinned to the tube and removed without gastrotomy (2b).
Source publication
Foreign body ingestion is a common problem in children. Safety pin ingestion is common in Turkey. We describe a new method of removal for safety pins in our 2 cases.
A 9-month-old girl and a 6-month-old boy had each ingested a safety pin. Abdominal X-rays detected the safety pins in their stomachs. At the end of 3 months, the foreign bodies still r...
Similar publications
Perforation of gut by sharp metallic objects is rare and rarer still is their migration to sites like liver. The symptoms may be non-specific and the discovery of foreign body may come as a radiological surprise to the unsuspecting clinician since the history of ingestion is difficult to obtain.
A unique case of a broken sewing needle in the liver...
A 16year old patient had ingested two sewing needles about 4.5cm long accidentally that eventually resided in extra intestinal tract position, and being asymptomatic, she ignored the problem for a long period about 2years. She only consulted the hospital after having symptoms. The needles were located by X-ray imaging and retrieved with the aid of...
Admittance in the emergency room with complaints of acute abdominal pain is a common scenario. Patients who see the doctor due to foreign object ingestion present transitory symptomatology. In most cases, foreign object ingestion in adults is accidental, although it may be linked to physiological, anatomical, mechanical, social and psychiatric fact...
Extraction of rectal foreign bodies is challenging. The medical literature confirms the diversity of the problem and equally some ingenious solutions, the majority of which requires either an anesthetic agent or a laparotomy to remove them. This case report presents a simple nonoperative technique to deal with one such situation.
Citations
... Other techniques used (if the pin is lying open towards the oral cavity) include pushing the pin into the stomach, reorienting it and subsequently pulling it out with its sharp tip pointing downwards. Turkyilmaz et al. used a small midline laparotomy to palpate the open safety pin in the stomach and pin it to the Ryle's tube, which was then brought out orally [9]. ...
Sharp foreign bodies in the oesophagus may present as an entirely asymptomatic child with only radiological evidence but require
emergent surgical management. Safety pins, razor blades and needles are a few of the commonly ingested sharp objects in developing
countries. The open safety pin is a particularly interesting clinical problem, as the management depends on its location and
orientation. Many methods and instruments have been used over the years to remove them from the upper digestive tract. We
present a novel method using the rigid paediatric bronchoscope and alligator forceps for the extraction of this unusual foreign
body from the oesophagus of a 6 year old girl.
... The frequency and the type of ingested sharps are greatly dependent on cultural factors. Esophageal fish bones are most frequently encountered in patients of Asian and Mediterranean descent, where it is customary to introduce fish into the diet at a young age (26), whereas pin ingestions are higher in ethnic groups that use pins to fasten clothing or for religious or cultural beliefs (27,28). Toothpick ingestions tend to be more prevalent among older age groups. ...
Foreign body ingestions in children are some of the most challenging clinical scenarios facing pediatric gastroenterologists. Determining the indications and timing for intervention requires assessment of patient size, type of object ingested, location, clinical symptoms, time since ingestion and myriad other factors. Often the easiest and least anxiety-producing decision is the one to proceed to endoscopic removal, rather than observation alone. Due to variability in pediatric patients' size, there are less firm guidelines available to determine which type of object will safely pass, as opposed to the clearer guidelines in the adult population. In addition, the imprecise nature of the histories often leaves the clinician to question the timing and nature of the ingestion. Furthermore, recent changes in the types of ingestions encountered, specifically button batteries and high-powered magnet ingestions, create an even greater potential for severe morbidity and mortality to children. As a result, clinical guidelines regarding management of these ingestions in children remain varied and sporadic, with little in the way of prospective data to guide their development. An expert panel of pediatric endoscopists was convened and produced this review that outlines practical clinical approaches to the pediatric patient with a variety of foreign body ingestions.This guideline is intended as an educational tool that may help inform pediatric endoscopists in managing foreign body ingestions in children. Medical decision-making, however, remains a complex process requiring integration of clinical data beyond the scope of these guidelines. These guidelines should therefore not be considered as a rule or as establishing a legal standard of care. Caregivers may well choose a course of action outside of those represented in these guidelines due to specific patient circumstances. Furthermore, additional clinical studies may be necessary to clarify aspects based on expert opinion rather than published data. Thus these guidelines may be revised as needed to account for new data, changes in clinical practice or availability of new technology.
... The frequency and the type of ingested sharps are greatly dependent on cultural factors. Esophageal fish bones are most frequently encountered in patients of Asian and Mediterranean descent, where it is customary to introduce fish into the diet at a young age (26), whereas pin ingestions are higher in ethnic groups that use pins to fasten clothing or for religious or cultural beliefs (27,28). Toothpick ingestions tend to be more prevalent among older age groups. ...
Endoscopy is a common and useful means of accessing the upper gastrointestinal tract for the purpose of retrieving ingested foreign bodies in children. The majority of foreign body ingestions occur in younger ages, with a peak incidence between the ages of 6 months and 6 years. Indications for removal depend upon a patient's age and size, the type and form of the swallowed item, its location as well as the clinical symptoms and time since ingestion. Esophageal impaction of a foreign body – whether it is blunt or sharp – requires more urgent intervention compared to more distally located foreign bodies. Food bolus impaction in children may indicate underlying esophageal pathology, such as eosinophilic esophagitis, peptic or other strictures, achalasia, and other motility disorders. Optimal endoscopic management of foreign bodies depends on their location and type.
Foreign body pin in the Oesophagus usually occurs in mentally challenged people or accidentally and is a very occurrence in emergency. Rarity, technical difficulty in removing the foreign body, complications associated with the delay in diagnosis and treatment, migration of the foreign body extraluminally and site, shape and position of the sharp end makes this entity interesting and worth reporting.
We report a mentally sound adult male who had accidental ingestion of sharp foreign body pin which migrated very early extraluminally that lead to a negative oesophagoscopy, and necessitated external removal.
Ingestion of foreign bodies is a common pediatric problem. The majority of ingested foreign bodies pass spontaneously. Management of foreign body ingestions varies based upon the object ingested, its location, and the patient's age and past history. Esophageal foreign bodies should be urgently removed because of their potential to cause complications. Ingested batteries that lodge in the esophagus, sharp or pointed foreign bodies in the esophageal or gastric tract, and ingestion of multiple magnets all require urgent endoscopic removal. Flexible endoscopy is the therapeutic modality of choice for most patients. The use of devices such as a latex protector hood or an overtube may facilitate safer extraction of sharp objects.
Interventional endoscopic procedures involving the gastrointestinal (GI) tract in children are very common. Over the last several years the number of procedures in this area has steadily increased.
To study indications and results of GI interventional endoscopies performed in a Pediatric GI unit.
Retrospective study over a period of 10 years (1999-2008). Data were collected from endoscopic files. All procedures were performed endoscopically under general anesthesia.
185 interventional endoscopic procedures were done during this period in 96 patients (58 boys) median age: 4.9±4.7 years (1 month-13 years). Indications were as follows: esophageal stenosis (n=46; 47.9%), rectal polyp resection (n=21; 19.8%), esophageal varices ligation (n=19; 19.7%), foreign body extractions (n=8; 8.3%) and percutaneous endoscopic gastrostomy (n=2; 2.1%). One hundred and thirteen esophageal dilations (61.1% of procedures) were performed in 46 patients: caustic stenosis (n=22; 22.9%), peptic stenosis (n=13; 13.5%) and anastomotic stenosis (n=11; 11.4%).
The main indication of interventional GI endoscopy in this series was oesophageal stenosis followed by rectal polyp resection, esophageal varices ligation and foreign body extractions.
Ingestion of foreign bodies is a common pediatric problem. The majority of ingested foreign bodies pass spontaneously. Management of foreign body ingestions varies based upon the object ingested, its location, and the patient's age and past history. Esophageal foreign bodies should be urgently removed because of their potential to cause complications. Ingested batteries that lodge in the esophagus, sharp or pointed foreign bodies in the esophageal or gastric tract, and ingestion of multiple magnets all require urgent endoscopic removal. Flexible endoscopy is the therapeutic modality of choice for most patients. The use of devices such as a latex protector hood or an overtube may facilitate safer extraction of sharp objects.
