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Wang FT, Gao RY, Wu TQ, Chen CQ. Management of duodenal foreign bodies using the novel combined laparoscopic and endoscopic approaches in two unique cases. Asian J Surg 2024; 47:2302-2303. [PMID: 38336487 DOI: 10.1016/j.asjsur.2024.01.162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 01/26/2024] [Indexed: 02/12/2024] Open
Affiliation(s)
- Fang-Tao Wang
- Diagnostic and Treatment Center for Refractory Diseases of Abdomen Surgery, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, 200072, China
| | - Ren-Yuan Gao
- Diagnostic and Treatment Center for Refractory Diseases of Abdomen Surgery, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, 200072, China
| | - Tian-Qi Wu
- Diagnostic and Treatment Center for Refractory Diseases of Abdomen Surgery, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, 200072, China
| | - Chun-Qiu Chen
- Diagnostic and Treatment Center for Refractory Diseases of Abdomen Surgery, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, 200072, China.
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Pokharel S, KC S, Lamichhane S, Pokharel M, Sah RP, Yadav SK, Bhusal A, Poudel S, Shah SK, Pokharel M. Asymptomatic spontaneous expulsion of a long foreign body through the gastrointestinal tract - a curious case report. Radiol Case Rep 2024; 19:1940-1944. [PMID: 38449486 PMCID: PMC10915782 DOI: 10.1016/j.radcr.2024.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 01/31/2024] [Accepted: 02/05/2024] [Indexed: 03/08/2024] Open
Abstract
Foreign body ingestion and its natural elimination are common in children. However, this is uncommon for long foreign bodies. Here, we report the spontaneous removal of an ingested pencil in an asymptomatic child. To our knowledge, this is the first case report of asymptomatic spontaneous elimination of a normally-sized ingested pencil. A 7-year-old male child presented with a history of ingestion of a pencil 4 hours back, without any complaints. Immediate abdominal radiography revealed a pencil in the stomach with an estimated length of approximately 10 cm and no signs of complications. He was conservatively treated under a semi-solid diet, presumably due to lack of available endoscopic option. Subsequently, he passed the pencil in stool within 24 hours of ingestion. He was asymptomatic and playful during the course and at discharge. Conservative management of a quickly moving long foreign body initially located below the esophagus in an asymptomatic child is possible with the help of imaging guidance, particularly in settings lacking an endoscopy. Although, this should not be considered a norm. However, this suggests that the treatment of ingested foreign bodies must be individualized. Thus, multiple factors related to the child and the foreign body must be assessed before committing to invasive procedures like laparotomy. Similarly, plain X-rays can be helpful even for radiolucent foreign bodies, for diagnosis and ruling out complications. All of these are vital in underdeveloped countries, where endoscopy and computed tomography facilities might be either lacking or unaffordable by patients.
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Affiliation(s)
- Sushan Pokharel
- Department of Pediatric Surgery Division, Department of General Surgery, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - Suraj KC
- Department of Pediatric Surgery Division, Department of General Surgery, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - Samiksha Lamichhane
- Department of Radiodiagnosis and Imaging, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - Mohir Pokharel
- Department of General Surgery, Kathmandu Medical College and Teaching Hospital, Kathmandu, Nepal
| | - Rajesh P. Sah
- Department of Pediatric Surgery Division, Department of Surgery, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - Sanjaya K. Yadav
- Department of Pediatric Surgery Division, Department of Surgery, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - Amrit Bhusal
- Department of Radiodiagnosis and Imaging, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - Sishir Poudel
- Department of Pediatric Surgery Division, Department of General Surgery, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - Siddhartha K. Shah
- Department of Pediatric Surgery Division, Department of General Surgery, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - Moneec Pokharel
- Birat Medical College and Teaching Hospital, Biratnagar, Nepal
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