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Pen Foreign Body Ingestion Mimicking Crohn's Disease in a Pediatric Patient
Julia R Donner1, Ann Ding2, Michael Herzlinger3
1Department of Pediatrics, Hasbro Children's Hospital and the Warren Alpert Medical School of Brown University, Providence RI.
Insights
Foreign body ingestion in children can mimic inflammatory bowel disease (IBD). A case highlights how a retained pen caused inflammation, mimicking Crohn's disease initially.
Area of Science:
- Pediatric Gastroenterology
- Gastrointestinal Pathology
Background:
- Foreign body ingestion is a frequent occurrence in pediatric patients, especially those with psychiatric conditions.
- Prolonged presence of foreign bodies can induce localized inflammation, leading to symptoms like weight loss, abdominal pain, and elevated inflammatory markers.
Observation:
- A 13-year-old patient intentionally ingested a pen.
- Clinical presentation included elevated inflammatory markers and terminal ileitis on imaging, raising suspicion for Crohn's disease.
Findings:
- Colonoscopy revealed that the terminal ileitis was caused by a foreign body reaction to the ingested pen.
- The inflammatory changes mimicked features of Crohn's disease.
Implications:
- This case underscores the importance of considering foreign body reactions in the differential diagnosis of pediatric inflammatory bowel disease.
- Accurate diagnosis is crucial to avoid misdiagnosis and ensure appropriate management, preventing unnecessary treatments for conditions like Crohn's disease.
Abstract:
Foreign body ingestion is common in pediatrics, particularly in children with psychiatric illness. Foreign bodies present for extended periods of time can trigger a local inflammatory reaction causing weight loss, abdominal pain, and elevated inflammatory markers, mimicking inflammatory bowel disease (IBD). We report a case of intentional pen ingestion in a 13-year-old, whose clinical presentation with elevated inflammatory markers and terminal ileitis suggested on imaging was initially suspicious for Crohn's disease but was found on colonoscopy to be due to foreign body reaction from ingestion of a pen.
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