A sharp lesson: Duodenal perforation 2 months after ingestionof a pin

Dalrymple, Rebecca Amy; Berry, Kathleen; Jester, Ingo

doi:10.4103/jiaps.jiaps_250_16

Cited by 3 publications

(2 citation statements)

References 5 publications

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“…Ingested foreign bodies generally pass through the gastrointestinal tract without complications. Less than 1% cause perforations [35][36][37][38]. Sharp and thin foreign bodies have been associated with a higher perforation risk.…”

Section: Foreign Bodiesmentioning

confidence: 99%

Diagnosis and management of duodenal perforations: a narrative review

Ansari

Torén

Lindberg

et al. 2019

Scandinavian Journal of Gastroenterology

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Duodenal perforation is a rare, but potentially life-threatening injury. Multiple etiologies are associated with duodenal perforations such as peptic ulcer disease, iatrogenic causes and trauma. Computed tomography with intravenous and oral contrast is the most valuable imaging technique to identify duodenal perforation. In some cases, surgical exploration may be necessary for diagnosis. Specific treatment depends upon the nature of the disease process that caused the perforation, the timing, location and extent of the injury and the clinical condition of the patient. Conservative management seems to be feasible in stable patients with sealed perforations. Immediate surgery is required for patients presenting with peritonitis and/or intra-abdominal sepsis. Minimally invasive techniques are safe and effective alternatives to conventional open surgery in selected patients with duodenal perforations. Here we review the current literature on duodenal perforations and discuss the outcomes of different treatment strategies. ARTICLE HISTORY

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Section: Foreign Bodiesmentioning

confidence: 99%

Diagnosis and management of duodenal perforations: a narrative review

Ansari

Torén

Lindberg

et al. 2019

Scandinavian Journal of Gastroenterology

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“…Dalrymple et al reported a patient with a perforation of the duodenum and liver with a localized pus collection, who presented with mild abdominal pain 2 months after pin ingestion. 18 There has been one report of death in a patient with hijab pin ingestion, although the details of this case are not clear. 19 These cases reveal the importance of ensuring adequate follow-up for asymptomatic patients discharged from the hospital without proof of passing the pin.…”

Section: Figurementioning

confidence: 90%

Hijab Pin Ingestions

Yogev¹,

Mahameed²,

Gileles‐Hillel³

et al. 2020

Pediatrics

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OBJECTIVES: To characterize the clinical manifestations, outcomes, and complications of hijab pin ingestion in adolescents and to identify risk factors for a need for intervention.METHODS: A retrospective review of patients ,25 years of age who presented to our emergency department because of hijab pin ingestion between 2007 and 2018. Comparison was performed between impaled and nonimpaled pins. RESULTS:We reviewed 1558 foreign-body ingestion cases. Of these, 208 (13.3%) patients presented because of hijab pin ingestion, with a total of 225 ingested pins. The mean patient age was 14.7 6 4.1 years, and 88% of patients were girls. Time from ingestion to presentation was 24 6 49.5 hours. Most pins were located in the stomach (46.6%), and 18.6% of all pins were impaled. Location in the stomach (odds ratio = 4.3 [95% confidence interval: 1.9-9.2]; P , .001) and abdominal tenderness on examination (odds ratio = 2.7 [95% confidence interval: 1.3-5.6]; P = .007) were strong independent risk factors for an impaled pin. Time to intervention was 22.9 hours, and 41 endoscopies were performed. One patient required laparoscopic surgery. No complications were observed. CONCLUSIONS:The hijab pin is an increasingly encountered foreign body in pediatric practice. Its specific clinical features distinguish it from other sharp objects. A delayed interventional approach in selected patients does not carry a higher risk of complications and results in significantly fewer interventions compared to existing guidelines. These findings will help guide pediatric specialists in this prevalent clinical scenario. Management recommendations are proposed.

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