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A Case Series of Ingested Open Safety Pin Removal Using a Proposed Endoscopic Removal Technique Algorithm
1Department of Pediatric Gastroenterology, University of Health Sciences, Yuksek Ihtisas Teaching Hospital, Bursa, Turkey.
Insights
Ingested safety pins in children are often found in the esophagus and stomach. Endoscopic removal is effective and recommended as soon as possible to prevent complications.
Area of Science:
- Pediatric Gastroenterology
- Endoscopic Procedures
- Foreign Body Ingestion
Background:
- Ingestion of safety pins is a significant concern in pediatric populations.
- It can lead to serious health issues, including morbidity and mortality.
Purpose of the Study:
- To provide practical management strategies for ingested safety pins in children.
- To introduce a novel algorithm for handling such cases.
Main Methods:
- Retrospective analysis of 20 pediatric cases with ingested safety pins over four years.
- Endoscopic examination to locate and remove foreign bodies.
Main Results:
- Safety pins were located in the esophagus, stomach, and duodenum in most cases.
- Endoscopic removal was successful in 75% of cases; no surgical intervention was required.
- No major complications like perforation or death occurred, with minor erosions being the only issue.
Conclusions:
- Endoscopic removal of ingested safety pins is a safe and effective procedure.
- Early endoscopic intervention for safety pin ingestion, particularly in the esophagus and stomach, is crucial.
- Prompt endoscopic procedures minimize risks and improve patient outcomes.
Purpose:
Safety pin ingestion is common in some regions of the world and may lead to severe morbidity and mortality. The aim of this study was to present some practical suggestions for ingested safety pins using an accompanying algorithm, presented for the first time in the literature to the best of our knowledge.
Methods:
Twenty children with ingested safety pins during a 4-year period were retrospectively included in the study.
Results:
Median age of patients was 9.5 months (interquartile range, 6.3-14 months), and 70% were girls. On endoscopic examination, safety pins were observed in the stomach (25%), duodenal bulb (20%), upper esophagus (15%), middle esophagus (10%), and second part of the duodenum (10%) but were not observed in 20% of the cases. Safety pins were removed using endoscopy in 15 cases (75%). In four cases (20%), no safety pin was observed on endoscopic examination. In one case (5%) involving a 6-month-old infant, the safety pin could not be removed although it was observed using endoscopy. No surgical intervention was needed for any patient. No complications such as perforation or deaths developed, except for erosions, due to the foreign body removal procedure.
Conclusion:
Safety pins are easily removed endoscopically. The best option is to remove the safety pin using endoscopy while it is still in the esophagus and stomach. For this reason, endoscopic procedures should be performed as soon as possible in children who have ingested safety pins.
