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VOLUME 13 , ISSUE 3 ( September-December, 2021 ) > List of Articles

CASE REPORT

An Open Safety Pin in an 8-month-old Child: A Rare Delayed and Unusual Presentation of This Dangerous Foreign Body

Sashikanth Jonnalgadda, Amjad Khan

Keywords : Child, Esophagoscopy, Esophagus, Foreign body esophagus, Neck, Unusual presentation, X-ray neck

Citation Information : Jonnalgadda S, Khan A. An Open Safety Pin in an 8-month-old Child: A Rare Delayed and Unusual Presentation of This Dangerous Foreign Body. Int J Otorhinolaryngol Clin 2021; 13 (3):136-138.

DOI: 10.5005/jp-journals-10003-1394

License: CC BY-NC 4.0

Published Online: 21-04-2022

Copyright Statement:  Copyright © 2021; The Author(s).


Abstract

Introduction: Foreign bodies (FBs) are common in young children aged 3 months to 6 years, and FBs in the esophagus can present with a wide variety of symptoms. We present an extremely rare case of chronic open safety pin (SP) in an 8-month-old child who was asymptomatic for 8 weeks and then presented with cough and neck spasms. Case history: An 8-month-old baby girl presented to us referred from a pediatrician with an incidental finding of open SP in the esophagus when a chest X-ray was performed to diagnose nonresponding cough. Patient had constant neck deviation towards right side without any other symptoms for 8 weeks, when X-ray diagnosed the FB. Flexible and rigid endoscopical removal were unsuccessful since the sharp end of the pin was buried in the luminal wall with granulation tissue surrounding it. Open neck exploration with esophagostomy and extraction of the SP under general anesthesia had to be done. The child is now asymptomatic with normal neck posture postprocedure. Conclusion: Open SP can have delayed presentation, and a high index of suspicion is required to diagnose the presence of an FB. Chronic FBs can penetrate the luminal wall of the esophagus resulting in granulation tissue, and this further leads to fixation of the FB making it extremely difficult to remove endoscopically. We advocate open neck exploration and esophagostomy for safe removal of chronic sharp FB like open SP.


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  1. American Academy of Family Physicians. MC. American family physician. American Academy of Family Physicians. 1970.
  2. Chen MK, Beierle EA. Gastrointestinal foreign bodies. Pediatr Ann 2001;30(12):736–742. DOI: 10.3928/0090-4481-20011201-08.
  3. Yahyaoui S, Jahaouat I, Brini I, et al. Delayed diagnosis of esophageal foreign body: a case report. Int J Surg Case Rep 2017;36:179–181. DOI: 10.1016/j.ijscr.2017.05.028.
  4. Kodituwakku R, Palmer S, Prosad Paul S. Management of foreign body ingestions in children: button batteries and magnets. Br J Nurs 2017;26(8):456–461. DOI: 10.12968/bjon.2017.26.8.456.
  5. Gün F, Salman T, Abbasoglu L, et al. Safety-pin ingestion in children: a cultural fact. Pediatr Surg Int 2003;19:482–484. DOI: 10.1007/s00383-003-0964-y.
  6. Passey JC, Meher R, Agarwal S, et al. Unusual complication of ingestion of a foreign body. J Laryngol Otol 2003;117:566–567. DOI: 10.1258/002221503322113049.
  7. Sarihan H, Kaklikkaya I, Ozcan F. Pediatric safety pin ingestion. J Cardiovasc Surg (Torino) 1998;39(4):515–518. PMID: 9788804.
  8. Kalayci A, Tander B, Kocak S, et al. Removal of open safety pins in infants by flexible endoscopy is effective and safe. J Laparoendosc Adv Surg Tech 2007;17:242–245. DOI: 0.1089/lap.2006.0060.
  9. Mohajeri G, Fakhari S, Ghaffarzadeh Z, et al. A case of the long time presence of a large foreign body in esophagus without complication. Adv Biomed Res 2016;5:205. DOI: 10.4103/2277-9175.191001.
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