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Pediatric safety pin ingestion
H Sarihan1, I Kaklikkaya, F Ozcan
1Department of Pediatric Surgery, Karadeniz Technical University, Faculty of Medicine, Trabzon, Turkey.
Insights
This study reviewed 15 children who ingested safety pins, finding most pins lodged in the upper esophagus. Endoscopic removal was effective, though one case required surgery due to duodenal lodging.
Area of Science:
- Pediatric Gastroenterology
- Foreign Body Ingestion
- Medical Device Complications
Background:
- Ingestion of foreign bodies, including safety pins, is a significant concern in pediatric patients.
- Safety pin ingestion can lead to various complications, from asymptomatic lodging to life-threatening conditions.
Purpose of the Study:
- To retrospectively evaluate the etiology and management of safety pin ingestion in children.
- To analyze the location, complications, and treatment outcomes of ingested safety pins in pediatric patients.
Main Methods:
- Retrospective review of 15 consecutive pediatric cases with ingested safety pins.
- Analysis of patient demographics, pin location, presenting symptoms, and management strategies.
- Evaluation of endoscopic and surgical interventions for safety pin removal.
Main Results:
- The mean age of patients was 5.4 years; 8 were male and 7 were female.
- Safety pins were most commonly found at the cricopharyngeus (9), followed by the esophagogastric junction (5) and aortic arch (1).
- Esophagoscopy successfully removed 9 pins; 6 passed spontaneously or during anesthesia, with one requiring laparotomy due to duodenal lodging.
Conclusions:
- Safety pin ingestion in children requires prompt evaluation and management.
- Endoscopic retrieval is the primary treatment modality, with a high success rate.
- Complications, though rare, necessitate careful monitoring and surgical intervention when indicated.
Abstract:
Fifteen consecutive children with ingested safety pins were evaluated retrospectively. Eight patients were males and seven were girls. The mean age of the patients was 5.4 years ranging from 7 months to 16 years. Two of 15 patients were mentally retarded Seven safety pins ingestion were noted by parents, three older children applied with safety pin swallowing. Three infants referred with hypersalivation and swallowing difficulty. One of two mentally retarded patients had recurrent aspiration pneumonia, the other had neck abscess. These patients' lesions were detected incidentally by thoracic X-ray. Nine safety pins were at the level of the cricopharyngeus, one at the level of the aortic arch and five at the esophagogastric junction. A right esophagoscopy was used for extraction of safety pins under general anesthesia and endotracheal intubation were used. Before esophagoscopy control plain X-ray was obtained for location of safety pin. Nine safety pins were extracted by esophagoscopy. Three safety pins spontaneously and three during anesthesia induction passed through the esophagus falling down the stomach. Five of these six safety pins were spontaneously extracted without complication. However one open safety pin lodged at the duodenum and laparotomy was required. In this article, etiology and management of safety pin ingestion in children are discussed.