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

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.

Colonoscopy for foreign body retrieval in ileocecal valve: a rare case report

“…Two cases were described by Lee et al . [ 6 ] and the others registered in the Navia-López et al . study [ 7 ].…”

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

“…The transit through the gastrointestinal tract is completed spontaneously in an average of 3.6 days [ 4 ]. Nevertheless, FB can impact at some point, causing dangerous consequences: about 20% of cases impact within the oesophagus where the FB can cause the formation of bronchoesophageal fistula, aortoesophageal fistula, oesophageal perforation with subsequent mediastinitis or abscess, complete oesophageal stricture or oesophageal obstruction, pulmonary oedema, oesophageal diverticulum [ 10 , 11 ]. The probability of impaction depends on the quality, shape, size of the foreign body, and the child's medical status.…”

“…The multiple possibilities occurring in the management of a child, who had ingested a foreign body, require complex skills for the paediatric surgeon, including the decision between intervention or not, experience in endoscopic retrieval, and in dealing with potentially life-threatening complications. The requirement of surgery or endoscopy, due to impaction, has not been quantified so far but it is estimated that about 20% of ingested foreign bodies may require endoscopic retrieval and in 1% of cases even surgical intervention [ 11 ]. Considering safety pins, it has been reported that 41% of safety pins transit spontaneously, 28.5% need an endoscopy, and 30.5% require surgical intervention [ 13 ], with the latter being more frequent in the case of open pins.…”

“…In the literature, there are only a few cases reported of colonoscopic removal of potentially dangerous foreign bodies in adults and only one case of a safety pin in a child extracted through colonoscopy performed after 4 days of hospitalization [ 11 ]. Success rates of the removal depend on the experience level of the endoscopist and device choice [ 15 ].…”

Endoscopic management of a nail-magnet aggregation impacted in the terminal ileum: a case report

“…Most endoscopic literature involving ingested inedible foreign objects relate to upper gastroscopy for removal of large, sharp or ulcerating objects that are pre-pyloric [ 7 , 8 ]. One report describes colonoscopy in children for a button cell and safety pin removal from the terminal ileum [ 9 ]. Objects >2–2.5 cm in diameter tend not to pass through the pylorus or ileocecal valve, and objects longer than 5–6 cm are restricted by the duodenal sweep [ 5 ].…”