Laparo-endoscopic combination for the safe extraction of an open safety pin in a 9-month-old child. Case report

Ann Med Surg (Lond). 2021 Aug 13:69:102716. doi: 10.1016/j.amsu.2021.102716. eCollection 2021 Sep.

Abstract

Introduction: and importance: Accidental ingestion of foreign bodies (FBs) is common among infants. In case of sharp FBs, the risk of accidental organ damage with potential life-threatening complications constitutes an absolute indication for removal. We present the case of a child, who, following the ingestion of an open safety pin, was successfully treated exclusively with minimally invasive techniques.

Case presentation: A 9-month-old male patient was admitted for hematemesis. An anteroposterior and lateral X-ray of the thorax and abdomen revealed the presence of an open safety pin in the epi-mesogastric region, without a precise localization. Upper and lower gastrointestinal endoscopy, fluoroscopy, and laparoscopy were combined in the same intervention to localize and safely remove the foreign body. The patient was dismissed on a postoperative day 1.

Clinical discussion and conclusion: The two main pitfalls of this scenario were the initially uncertain location of the foreign body and the young age of the patient. A combination of different techniques was used to safely locate and remove the foreign body, reducing hospitalization and avoiding repeated radiological exposure. An experienced team in a tertiary paediatric surgical and endoscopic centre increases the chances of success and minimizes invasiveness and the risk of complications.

Keywords: Case report; Child; Mini-invasive extraction; Open safety pin; Sharp foreign body.

Publication types

  • Case Reports