Pediatr Gastroenterol Hepatol Nutr.  2017 Sep;20(3):204-209. 10.5223/pghn.2017.20.3.204.

Two Cases of Colonoscopic Retrieval of a Foreign Body in Children: A Button Battery and an Open Safety Pin

Affiliations
  • 1Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea. hryang@snubh.org
  • 2Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea.

Abstract

Ingestion of foreign body in children is a relatively common problem among paediatric population. The foreign bodies mostly pass spontaneously through the gastrointestinal tract. However, complications can occur according to its anatomical location, the characteristics of the foreign body, and delays in management. Although the cases of ingested button batteries or sharp objects impacted at the gastrointestinal tract can be very serious, there have been very only a few cases have reported colonoscopic removal of these dangerous foreign bodies in adults, and there have been no case reports in children. We report one case of a button battery and one case of an open safety pin, both impacted in the terminal ileum that had moved from the stomach within a few hours of ingestion and were eventually managed by colonoscopy without any complications.

Keyword

Foreign body; Colonoscopy; Button battery; Safety pin; Child

MeSH Terms

Adult
Child*
Colonoscopy
Eating
Foreign Bodies*
Gastrointestinal Tract
Humans
Ileum
Stomach

Figure

  • Fig. 1 (A) Abdominal radiograph on day 1 showing the disc battery in the stomach. (B) Day 3 X-ray showing that the disc battery had moved to the ileocecal valve. (C) Abdominal radiograph just before the colonoscopic retrieval, revealing long stagnation of the disc battery at the same site. (D) Skiagram after the colonoscopic retrieval, indicating a successful removal without any complications.

  • Fig. 2 (A) An ingested button battery observed in the terminal ileum and then moved to the cecum during colonoscopy. (B) A button battery successfully removed by using a magnetic probe during colonoscopy. (C) Magnetic probe used to remove a button battery.

  • Fig. 3 (A) Abdominal radiograph on day 1 showing a 2-cm-sized open safety pin in the stomach. (B) At 6 hours post-admission, the open safety pin had moved to the lower abdomen. (C) Abdominal X-ray on day 2 shows the open safety pin at the right lower abdomen. (D) Serial X-ray just before the colonoscopic retrieval on day 3, revealed an impacted open safety pin at the same site near the ileocecal valve. (E) Abdominal X-ray after colonoscopic retrieval showed only paralytic ileus without any complications.

  • Fig. 4 (A) An open safety pin found in the cecum during colonoscopy. (B) Foreign body removal was tried initially by using an alligator forceps but failed. (C) A tripod forceps used to remove an open safety pin. (D) An open safety pin was successfully removed by using a tripod forceps during colonoscopy. (E) After removing an open safety pin from the cecum, minor mucosal injury was observed at the site of foreign body impaction. (F) An open safety pin successfully removed by using a tripod forceps during colonoscopy.


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